Female Urogenital Diseases and Pregnancy Complications Commons^™

Model Assessment And Development Of Risk Stratification Of Surgical Site Infection Following Cesarean Delivery For A High-Risk, Urban Population, Dakisha N. Lewis, Nicole P. Salvo, Kiley A. Bernhard, Danielle M. Greer

Nicole P. Salvo, MD

Background: Surgical site infection (SSI) remains a major cause of morbidity despite efforts aimed at prevention and treatment. Risk stratification tools identify patients at greatest risk of SSI. Two models of stratification are: 1) the Centers for Disease Control and Prevention’s National Healthcare Safety Network SSI Risk Index (NHSN), which assigns risk based on surgery duration, surgical wound contamination and physical status; and 2) the New Risk Stratification Schema (NRSS). The NRSS aimed to improve upon NHSN by incorporating five variables: diabetes control, body mass index (BMI), chorioamnionitis, methods of placental extraction and skin closure.

Purpose: Our objectives were ...

Association Between First Trimester Pregnancy Associated Plasma Protein–A And The Development Of Gestational Diabetes Mellitus, Aylin Sert, Katherine Leung, Molly E. Waring, Raziel Rojas-Rodriguez, Silvia Corvera, Tiffany A. Moore Simas

UMass Center for Clinical and Translational Science Research Retreat

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism.

Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk.

Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014, 2015) was assembled by ...

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

UMass Center for Clinical and Translational Science Research Retreat

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 ...

Discovery And Development Of Human Monoclonal Antibodies To Block Rhd Alloimmunization During Pregnancy, Tushar Gupta, Melissa Gawron, Colby A. Souders, Michael A. Brehm, Dale Greiner, Leonard D. Shultz, Smita Jaiswal, Sean Mccauley, Ann Dauphin, Jeremy Luban, Lisa Cavacini

UMass Center for Clinical and Translational Science Research Retreat

Exposure of an Rh negative mother to red blood cells (RBCs) of an Rh positive fetus results in alloimmunization and development of anti-RhD antibodies. The anti-RhD antibodies cause hemolytic disease of the new born babies during subsequent pregnancies. Current prophylactic treatment involves polyclonal anti-RhD IgG purified from plasma of humans and is administered in approximately 20% of pregnancies. While the current prophylaxis is effective, it involves the use of human plasma and non-RhD specific antibodies, thus posing a risk of transmitting infections and undesired antibody reactions. Moreover, there is a serious scarcity of plasma donors to meet the requirement of ...

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all ...

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Dennis J. Baumgardner. MD

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305 ...

The Incidence Of Malignancy And The Preoperative Assessment Of Women Undergoing Hysterectomy With Morcellation For Benign Indications, Gianna L. Wilkie, Emily Reus, Katherine G. Leung, Leslie Bradford, Mark Manning, Tiffany A. Moore Simas

Senior Scholars Program

Background: The use of power morcellation in gynecologic surgery has come under scrutiny secondary to concerns for occult malignancy dissemination. The incidence of undiagnosed gynecologic malignancy when hysterectomy performed for benign indications is not definitive but has been quoted as high as 2.7% (1:37). There is not a standard recommended preoperative evaluation, and variation is anticipated by preoperative complaint or diagnosis.

Objectives: To quantify the malignancy incidence in women undergoing hysterectomy for benign indications and to compare the preoperative evaluation of patients undergoing hysterectomy with and without morcellation.

Methods: Retrospective cohort of women undergoing hysterectomies between October 2007 ...

Evaluating Use Of Higher Dose Oxybutynin In Combination With Desmopressin For Refractory Nocturnal Enuresis, Aaron Berkenwald, Jacqueline Pires, Pamela Ellsworth

Senior Scholars Program

Background: Nocturnal enuresis is a common pediatric condition with limited treatment options. In older children, pharmacologic therapy is often the preferred treatment. Pharmacologic therapies including Desmopressin (DDAVP) or Imipramine are effective in 40-50% of children. However Imipramine has serious safety concerns. DDAVP in combination with a fixed dose anticholinergic has been shown to be useful in individuals who fail DDAVP monotherapy, but still fails to achieve success rates greater than 60%.

Objective: Our goal is to explore the efficacy and safety of using combination therapy DDAVP plus Oxybutynin with increasing dose ofOxybutynin in patients refractory to standard combination therapy.

Study ...

Association Between First Trimester Pregnancy Associated Plasma Protein–A (Papp-A) And Gestational Diabetes Mellitus Development, Aylin Sert, Katherine Leung, Molly E. Waring, Raziel Rojas-Rodriguez, Silvia Corvera, Tiffany A. Moore Simas

Senior Scholars Program

Background: Gestational diabetes (GDM) is a common pregnancy complication with significant cardiometabolic consequences for mothers and offspring. Previous research from our group suggests that adipose tissue IGFBP-5 and its unique metalloprotease PAPP-A (Pregnancy Associated Plasma Protein-A) may play mechanistic roles in GDM development by regulating functional IGF-1 levels and lipid storage and metabolism.

Aim: To examine the relationship between circulating PAPP-A levels and GDM development. We hypothesized that high first trimester PAPP-A levels would be associated with decreased GDM risk.

Methods: A retrospective cohort of women delivering singleton gestations at UMass Memorial Healthcare (2009, 2010, 2014 ...

Geographic Distribution Of Maternal Group B Streptococcus Colonization And Infant Death During Birth Hospitalization: Eastern Wisconsin, Jessica J. F. Kram, Dennis J. Baumgardner, Kiley B. Vander Wyst, Melissa A. Lemke

Journal of Patient-Centered Research and Reviews

Purpose

Maternal group B Streptococcus (GBS) can be transmitted from a colonized mother to newborn during vaginal delivery and may or may not contribute to infant death. This study aimed to explore the geographic distribution and risk factors of maternal GBS colonization and infant death during birth hospitalization.

Methods

We retrospectively studied mothers with live birth(s) in a large eastern Wisconsin hospital system from 2007 through 2013. Associations between maternal and neonatal variables, GBS colonization and infant death were examined using chi-squared, Mann-Whitney U and t-tests. Multivariable logistic regression models also were developed.

Results

Study population (N = 99,305 ...

Contraception, Abortion And Assisted Fertility Among Muslim Women A Look At Islamic Culture And Policy In Iran And Afghanistan, Hayley Jacobsen

What All Americans Should Know About Women in the Muslim World

Discourse on women's reproductive rights through the lens of Muslim culture. The use of contraception, assisted fertility and abortion, are analyzed in Iran and Afghanistan. The culture surrounding family planning is detailed through a woman’s community, family, religion and the laws that govern the society they live in, which all influence her decision making in these matters. This piece stands as a cultural analysis of women's agency specifically in Middle Eastern Muslim culture, as it stands as a part of a global women's rights movement.

Tools And Methods For Zika Prevention In Cachoeira, Bahia, Florence Tesha

Independent Study Project (ISP) Collection

Zika virus, which is mainly transmitted by Aedes aegypti and Aedes albopictus mosquitoes, has become a major health threat in Brazil and other Latin American countries. Brazil is the country that is being most impacted with zika virus in addition to the existing mosquito-borne diseases of dengue and chikungunya. With the increase in zika virus infections, there have also been increasing numbers of infant brain abnormalities such as microcephaly associated to zika. International and local health institutions are working together to control and prevent zika transmission. This project aimed to investigate the various tools and methods employed by the Center ...

Neglect Amidst The Zika Epidemic: A Case Study On The Reach Of Government Campaigns And Resources In Quilombo Community Praia Grande, Bahia, Jenna Sherman

Independent Study Project (ISP) Collection

In response to the ongoing Zika epidemic in Brazil, a nationwide campaign has recently been launched targeting the eradication of mosquitoes, preventing the contraction of Zika, and deterring pregnancies. Many remote areas of Brazil, however, may not be being reached by these campaigns or resources to the same extent as more urban or affluent areas of Brazil—despite the existence of the universal healthcare system Sistema Único de Saúde (SUS). My objective, therefore, is to assess which media and on-ground campaigns regarding Zika have reached the minute island town of Praia Grande—a rural fishing Quilombo community of approximately 2 ...

La Accesibilidad Al Test De Vph Y Al Papanicolaou Para La Prevención Del Cáncer Cervicouterino En Servicios Públicos De Salud En San Miguel De Tucumán Según La Perspectiva De Los Profesionales De Salud, Eve Cleghorn

Independent Study Project (ISP) Collection

Información contextual: El cáncer cervicouterino es causado por el Virus del Papiloma Humano (VPH) y todavía es un problema actual en Argentina, con alrededor de 5.000 casos nuevos y 1.800 muertes cada año. Sin embargo, es muy prevenible debido a que es una enfermedad de crecimiento lento, y con herramientas correctas de tamizaje y diagnóstico. Estas incluyen la vacuna contra diferente tipos de VPH de alto riesgo y el Papanicolaou, un procedimiento en el cual se examinan las células del cuello de útero que podrían ser indicios de lesiones pre-cancerosas o cancerosas, las cuales pueden ser tratadas. Además ...

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low ...

Contraceptive Utilization And Downstream Feto-Maternal Outcomes For Women With Substance Use Disorders: A Dissertation, Gillian J. Griffith

GSBS Dissertations and Theses

Background: One in ten people in the U.S. are affected by a substance use disorder (SUD), roughly one third of whom are women. Rates of unintended pregnancy are higher in this population than in the general public. Little is understood about how women with SUD use prescription contraception and think about pregnancy.

Methods: By analyzing Medicaid claims data and conducting qualitative interviews with women with SUD, this doctoral thesis seeks to: 1) compare any use of and consistent, continued coverage by prescription contraceptives between women with and without SUD; 2) determine the extent to which SUD is associated with ...

Spontaneous Coronary Artery Dissection In A Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report, Peeyush Grover, Timothy P. Fitzgibbons

Open Access Articles

BACKGROUND: Spontaneous coronary artery dissection is an uncommon syndrome. Its prevalence among patients with polycystic kidney disease is very rare, with no previously reported involvement of the right posterior descending coronary artery.

CASE PRESENTATION: We describe the case of a middle-aged Caucasian woman with polycystic kidney disease who presented with a non-ST elevation myocardial infarction. Cardiac catheterization revealed a dissection of her right posterior descending coronary artery. She was treated with dual antiplatelet therapy and had a favorable outcome.

CONCLUSION: We report a rare and interesting case of spontaneous coronary artery dissection of the right posterior descending coronary artery in ...

Comparative Effectiveness Of Statin Therapy In Chronic Kidney Disease And Acute Myocardial Infarction: A Retrospective Cohort Study, David Smith, Eric Johnson, Denise Boudreau, Andrea Cassidy-Bushrow, Stephen Fortmann, Robert Greenlee, Jerry Gurwitz, David Magid, Catherine Mcneal, Kristi Reynolds, Steven Steinhubl, Micah Thorp, Jeffrey Tom, Suma Vupputuri, Jeffrey Vanwormer, Jessica Weinstein, Xiuhai Yang, Alan Go, Stephen Sidney

Jerry H. Gurwitz

BACKGROUND: Whether there is a kidney function threshold to statin effectiveness in patients with acute myocardial infarction is poorly understood. Our study sought to help fill this gap in clinical knowledge.

METHODS: We undertook a new-user cohort study of the effectiveness of statin therapy by level of estimated glomerular filtration rate (eGFR) in adults who were hospitalized for myocardial infarction between 2000 and 2008. Data came from the Cardiovascular Research Network. The primary clinical outcomes were 1-year all-cause mortality and cardiovascular hospitalizations, with adverse outcomes of myopathy and development of diabetes mellitus. We calculated incidence rates, the number needed to ...

The Integration Of Mobile Technology To Lower The Risk Of Developing Cervical Cancer In Hiv Positive Women, Tugce Kinik

Dissertations, Master's Theses and Master's Reports

Cervical cancer is the most common cancer in HIV positive women in the world [1]. According to epidemiologists, HPV infection alone will not initiate cervical cancer [2]. In addition to high risk HPV types, smoking, long term hormonal contraceptive use, high parity, HIV/AIDS infection, sexual activity before 20 years of age, multiple sexual partners, exposure to sexually transmitted disease, and family history of cervical cancer are other reasons to turn an HPV infection to the cervical cancer [3]. With the increasing global population, cervical cancer cases are expected to increase 46% until 2030 [4]. Effective prevention and control efforts ...

Genetic And Epigenetic Mechanisms Of Complex Reproductive Disorders, Bhavi P. Modi

Theses and Dissertations

Common, complex disorders are polygenic and multifactorial traits representing interactions between environmental, genetic and epigenetic risk factors. More often than not, contributions of these risk factors have been studied individually and this is especially true for complex reproductive traits where application of genomic technologies has been challenging and slow to progress. This thesis explores the potential of genetic and epigenetic components contributing to a better understanding of the biological pathways underlying disease risk in two specific female complex reproductive traits - polycystic ovary syndrome (PCOS) and preterm premature rupture of membranes (PPROM). The PCOS projects focus on characterization of a gene ...