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The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey 2017 Dominican University of California

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses and Capstone Projects

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin ...


Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir 2017 Aga Khan University

Maternal And Fetal Complications Of Antiphospholipid Syndrome: A Case Report With Long-Term Follow-Up, Tahira Naru, Mohammad Khurshid, Zafar Nazir

Zafar Nazir

We report a case of a 26- year old woman having antiphospholipid syndrome in pregnancy with long-term follow up. She presented with recurrent miscarriages, venous thrombosis, avascular necrosis of femoral head, mid-cerebral artery infarction and skin ulcers. Antiphospholipid syndrome is a recognized disorder of pregnancy. Diagnosis requires a high index of suspicion when evaluating women with recurrent pregnancy losses and vascular thrombosis. A low dose aspirin combined with heparin can reduce morbidity and improves the pregnancy outcome.


Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey 2017 University of Massachusetts Medical School

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Heather Z Sankey MD

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8 ...


Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey 2017 University of Massachusetts Medical School

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Tiffany A. Moore Simas

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8). GWG was positively associated with neonate birth size (p < 0.001). Interventions targeting prepregnancy overweight or obese women and those with excessive first-trimester GWG are needed.


Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey 2017 University of Massachusetts Medical School

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Milagros C. Rosal

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8). GWG was positively associated with neonate birth size (p < 0.001). Interventions targeting prepregnancy overweight or obese women and those with excessive first-trimester GWG are needed.


Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey 2017 University of Massachusetts Medical School

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Sybil L. Crawford

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8 ...


Snail-Cathepsin L Signaling In Human Breast And Prostate Cancers, LizaJoy Burton 2017 Clark Atlanta University

Snail-Cathepsin L Signaling In Human Breast And Prostate Cancers, Lizajoy Burton

Electronic Theses & Dissertations Collection for Atlanta University & Clark Atlanta University

Prostate and breast cancer are the leading causes of cancer-related death in men and women, respectively, and metastasis is the primary factor underlying the high mortality rates.1 Snail transcription factor is an important molecule that drives prostate and breast cancer metastasis through the process of epithelial mesenchymal transition (EMT). Proteolytic enzymes that promote invasion and metastasis such as the lysosomal cysteine protease cathepsin L (Cat L) have been shown to degrade E-cadherin, promoting the epithelial mesenchymal transition (EMT).2 It has also been shown that silencing Cat L can inhibit transforming growth factor-beta (TGF-β)-mediated EMT by suppressing Snail ...


Cranberry Juice Vs. Placebo As Prophylaxis For Recurrent Urinary Tract Infection In Adult Women: A Systematic Review, Donald S. Trawick, Hinda Mezaache 2017 James Madison University

Cranberry Juice Vs. Placebo As Prophylaxis For Recurrent Urinary Tract Infection In Adult Women: A Systematic Review, Donald S. Trawick, Hinda Mezaache

Physician Assistant Capstones

Objective: To determine the effectiveness of cranberry juice consumption as prophylaxis for urinary tract infection (UTI) in women with a history of recurrent UTI. Methods: Systematic literature review using Google Scholar with search terms “cranberry juice prophylaxis.” Results: Our search resulted in three randomized-control trials (RCTs), two of which demonstrated no benefit of cranberry juice in preventing recurrent UTI. Conclusion: Because of the significant heterogeneity among published studies, there is no definitive proof that cranberry juice is effective or useless as UTI prophylaxis.


The Rejoice Trial: A Phase 3 Randomized, Controlled Trial Evaluating The Safety And Efficacy Of A Novel Vaginal Estradiol Soft-Gel Capsule For Symptomatic Vulvar And Vaginal Atrophy., Ginger D Constantine, James A Simon, James H Pickar, David F Archer, Harvey Kushner, Brian Bernick, Gina Gasper, Shelli Graham, Sebastian Mirkin 2017 George Washington University

The Rejoice Trial: A Phase 3 Randomized, Controlled Trial Evaluating The Safety And Efficacy Of A Novel Vaginal Estradiol Soft-Gel Capsule For Symptomatic Vulvar And Vaginal Atrophy., Ginger D Constantine, James A Simon, James H Pickar, David F Archer, Harvey Kushner, Brian Bernick, Gina Gasper, Shelli Graham, Sebastian Mirkin

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: To evaluate the safety and efficacy of TX-004HR vaginal estradiol soft-gel capsules for moderate-to-severe dyspareunia associated with postmenopausal vulvar and vaginal atrophy.

METHODS: In this randomized, double-blind, placebo-controlled, phase 3 study, postmenopausal women with a self-identified most bothersome symptom of dyspareunia received 4, 10, or 25 μg TX-004HR or placebo for 12 weeks. Four co-primary efficacy endpoints were change from baseline to week 12 in percentages of superficial and parabasal cells, vaginal pH, and severity of dyspareunia. Secondary endpoints included severity of vaginal dryness and vulvar and/or vaginal itching or irritation. Endometrial histology and adverse events (AEs) were ...


Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim 2017 Aga Khan University

Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim

Department of Obstetrics & Gynaecology

Objective: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins.

Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to December 2012. . Cases of both monochorionic diamniotic and dichorionic diamniotic twin pregnancies were included. SPSS 19 was used for data analysis.

Results: Of the 394 cases, 84(21.3%) were monochorionic diamniotic twins and 310(78.7%) were dichorionic diamniotic twins. There were no cases of stillbirth beyond 30 and 34 weeks in monochorionic and dichorionic twins, respectively. Neonatal mortality stood ...


Evaluation Of Progesterone Agent Utilization And Birth Outcomes In A State Medicaid Plan, Tasmina Hydery, Mylissa K. Price, Bonnie C. Greenwood, Mito Takeshita, Rose Mauro, Parag Kunte, Kimberly J. Lenz, Paul L. Jeffrey 2017 University of Massachusetts Medical School

Evaluation Of Progesterone Agent Utilization And Birth Outcomes In A State Medicaid Plan, Tasmina Hydery, Mylissa K. Price, Bonnie C. Greenwood, Mito Takeshita, Rose Mauro, Parag Kunte, Kimberly J. Lenz, Paul L. Jeffrey

Commonwealth Medicine Publications

An analysis of medication adherence and birth outcomes among members receiving progesterone for the prevention of preterm birth in a state Medicaid program. Data is also used to evaluate the association between member characteristics and medication adherence and birth outcomes as well as whether there was a change in the cost of care.


A Pilot Study To Assess The Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women At High Risk For Gestational Diabetes Mellitus, Ling Shi, Vidya Iyer, Emily Jones, Tiffany A. Moore Simas, Alice H. Lichtenstein, Laura L. Hayman 2017 University of Massachusetts Boston

A Pilot Study To Assess The Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women At High Risk For Gestational Diabetes Mellitus, Ling Shi, Vidya Iyer, Emily Jones, Tiffany A. Moore Simas, Alice H. Lichtenstein, Laura L. Hayman

Laura L. Hayman

Background: Diet plays an important role in the prevention and management of gestational diabetes mellitus (GDM). Previous studies suggest that soy protein and isoflavones may have beneficial effects on lipid and glucose metabolism. Little is known regarding the cardiometabolic effects of soy intake during pregnancy. This pilot study assessed the feasibility, safety and acceptability of daily consumption of soy foods during pregnancy in women at high risk for GDM, and participant adherence to their assigned treatment.

Methods: A randomized controlled trial (RCT) was conducted among pregnant women at high risk for GDM. The Soy group were counseled to consume a ...


A Hemodialysis Cohort Study Of Protocol-Based Anticoagulation Management, Steven Lamontagne, Tinzar Basein, Binyue Chang, Lakshmi Mallela 2017 University of Massachusetts Medical School

A Hemodialysis Cohort Study Of Protocol-Based Anticoagulation Management, Steven Lamontagne, Tinzar Basein, Binyue Chang, Lakshmi Mallela

Open Access Articles

BACKGROUND: Chronic hemodialysis patients frequently require anticoagulation treatment with warfarin for a variety of co-morbidities. The optimal method for monitoring and dose adjustment of warfarin-based anticoagulation in this population, however, remains unclear. To examine this more closely, we reviewed all hemodialysis patients at a single institution on chronic warfarin therapy for a 10-month period prior to and after the institution of a standardized protocol for warfarin dose adjustment and monitoring. Anticoagulation efficacy was assessed by time within the therapeutic INR range (TTR), and resource utilization was assessed by the number of weekly INR measurements required for monitoring.

RESULTS: We retrospectively ...


Recreational Physical Activity And Premenstrual Syndrome In Young Adult Women: A Cross-Sectional Study, Aimee R. Kroll-Desrosiers, Alayne G. Ronnenberg, Sofija E. Zagarins, Serena C. Houghton, Biki B. Takashima-Uebelhoer, Elizabeth R. Bertone-Johnson 2017 University of Massachusetts Medical School

Recreational Physical Activity And Premenstrual Syndrome In Young Adult Women: A Cross-Sectional Study, Aimee R. Kroll-Desrosiers, Alayne G. Ronnenberg, Sofija E. Zagarins, Serena C. Houghton, Biki B. Takashima-Uebelhoer, Elizabeth R. Bertone-Johnson

Open Access Articles

INTRODUCTION: It is estimated that up to 75% of premenopausal women experience at least one premenstrual symptom and 8-20% meet clinical criteria for premenstrual syndrome. Premenstrual syndrome substantially reduces quality of life for many women of reproductive age, with pharmaceutical treatments having limited efficacy and substantial side effects. Physical activity has been recommended as a method of reducing menstrual symptom severity. However, this recommendation is based on relatively little evidence, and the relationship between physical activity, premenstrual symptoms, and premenstrual syndrome remains unclear.

METHODS: We evaluated the relationship between physical activity and premenstrual syndrome and premenstrual symptoms among 414 women ...


University Of Montana Students And The Gardasil Vaccine, Markie C. Glidewell 2017 The University Of Montana

University Of Montana Students And The Gardasil Vaccine, Markie C. Glidewell

Undergraduate Theses and Professional Papers

Gardasil® is a vaccine for human papilloma virus (HPV), a sexually transmitted virus that can cause genital warts, cervical cancer, and other diseases. Males and females ages 9-26 are recommended to receive the Gardasil® vaccination. Most students attending the University of Montana (UM) are within the recommended age range for Gardasil® vaccination and would benefit from receiving it if they have not yet done so. Gardasil® is available at the Health Services Pharmacy on the UM campus and is often covered by insurance plans with no patient copay. In the fall semester of 2016, surveys were given to patients at ...


A Low-Cost Time-Lapse Imaging System Developed For Documentation Of Human Pre-Implantation Embryogenesis In Clinical Ivf Settings, Christine E. Hennigan Miss 2017 University of Colorado Boulder

A Low-Cost Time-Lapse Imaging System Developed For Documentation Of Human Pre-Implantation Embryogenesis In Clinical Ivf Settings, Christine E. Hennigan Miss

Undergraduate Honors Theses

Infertility is a disease of the reproductive system that affects many women of various ages, races, and socioeconomic factors across the world (CDC, WHO, 2017). The expensive nature of treatments for infertility, such as in vitro fertilization (IVF), has been combated with a simplified culture system (SCS) developed in the Van Blerkom lab (Van Blerkom et al., 2013). This recent advancement in clinical IVF procedures has prompted an effort to develop additional, low-cost technology able to help assess pre-implantation embryogenesis development and competence. This study examines the development and application of a low-cost, simplified, time-lapse imaging system that has shown ...


Hpv Vaccine Reminders At The Point Of Service: Efficacy And Missed Opportunities. A Claims Based Study Within One Health Plan, B. Dale Magee, Katherine G. Leung, Tiffany A. Moore Simas 2016 University of Massachusetts Medical School

Hpv Vaccine Reminders At The Point Of Service: Efficacy And Missed Opportunities. A Claims Based Study Within One Health Plan, B. Dale Magee, Katherine G. Leung, Tiffany A. Moore Simas

B. Dale Magee

Introduction: Our objective is to assess HPV vaccine series completion rates, whether on-screen Point of Service reminders (POS) make a difference, and missed opportunities for reminders to have an effect.

Methods: Retrospective, claims-based study of females aged 9-26 receiving an initial dose of HPV vaccine during 2 periods: before (period 1) and after (period 2) implementation of a POS reminder system in 1(“Change Group”) of 2 physician groups using EHRs for both periods. Completion rates, and missed opportunities during eligible periods were calculated for those with continuous enrollment in the health plan investigated.

Results: Completion rates within 1 year ...


Tx-004hr Vaginal Estradiol Has Negligible To Very Low Systemic Absorption Of Estradiol., David F Archer, Ginger D Constantine, James A Simon, Harvey Kushner, Philip Mayer, Brian Bernick, Shelli Graham, Sebastian Mirkin, REJOICE Study Group. 2016 George Washington University

Tx-004hr Vaginal Estradiol Has Negligible To Very Low Systemic Absorption Of Estradiol., David F Archer, Ginger D Constantine, James A Simon, Harvey Kushner, Philip Mayer, Brian Bernick, Shelli Graham, Sebastian Mirkin, Rejoice Study Group.

Obstetrics and Gynecology Faculty Publications

OBJECTIVE: To evaluate the pharmacokinetics of TX-004HR vaginal estradiol softgel capsules when used for treating moderate-to-severe dyspareunia in postmenopausal women with vulvar and vaginal atrophy.

METHODS: A substudy of the REJOICE trial (multicenter, double-blind, placebo-controlled, phase 3) evaluated the pharmacokinetics of 4, 10, and 25-μg TX-004HR doses once/d for 2 weeks, followed by twice/wk for 10 weeks. Serum samples obtained at 2, 4, 6, 10, and 24 hours postdose on days 1 and 14, and once on day 84, were analyzed for area under the serum concentration-time curve, tmax, Cmin, Cavg, and Cmax for estradiol, estrone, and estrone ...


Hpv Vaccine Reminders At The Point Of Service: Efficacy And Missed Opportunities. A Claims Based Study Within One Health Plan, B. Dale Magee, Katherine G. Leung, Tiffany A. Moore Simas 2016 University of Massachusetts Medical School

Hpv Vaccine Reminders At The Point Of Service: Efficacy And Missed Opportunities. A Claims Based Study Within One Health Plan, B. Dale Magee, Katherine G. Leung, Tiffany A. Moore Simas

Obstetrics and Gynecology Publications and Presentations

Introduction: Our objective is to assess HPV vaccine series completion rates, whether on-screen Point of Service reminders (POS) make a difference, and missed opportunities for reminders to have an effect.

Methods: Retrospective, claims-based study of females aged 9-26 receiving an initial dose of HPV vaccine during 2 periods: before (period 1) and after (period 2) implementation of a POS reminder system in 1(“Change Group”) of 2 physician groups using EHRs for both periods. Completion rates, and missed opportunities during eligible periods were calculated for those with continuous enrollment in the health plan investigated.

Results: Completion rates within 1 year ...


Vulvodynia; An Under-Recognized Disease, Simona Roxana Georgescu, Cristina I. Mitran, Mădălina I. Mitran, Maria I. Sârbu, Mircea Tampa 2016 Carol Davila University, Department of Dermatology and Venereology

Vulvodynia; An Under-Recognized Disease, Simona Roxana Georgescu, Cristina I. Mitran, Mădălina I. Mitran, Maria I. Sârbu, Mircea Tampa

Journal of Mind and Medical Sciences

Vulvodynia is a chronic condition which affects an increasing number of women; it presents currently an incidence that is higher than had previously been estimated. Regarding pathogenesis, several (hormonal, infectious, inflammatory and psychological) factors have been proposed, but vulvodynia etiology remains still unclear. This disorder is a multifactorial condition with a significant impact on the patient’s quality of life, yet is difficult to diagnose (an under-estimated/ under-recognized affection). Certain medical investigations are required in order to exclude other diseases (the diagnosis of vulvodynia being one of exclusion), but anamnesis and physical examination are essential steps in the diagnosis.

Although ...


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