Digital Commons Network^™

Safely Placing Mesh In Multi-Recurrent Right Inguinal Hernia Repair With Appendectomy, Nicole Hadjiloucas Md, Nicholas Armstrong Md

Scientific Day

Introduction/Background:

Patient is a 54-year-old male with a history of 5 prior inguinal hernia repairs with multiple layers of mesh who presented to our office with discomfort in his right groin, seeking elective repair. During our procedure multiple meshes were encountered, including a portion of Marlex mesh encompassing the appendix. A decision was made at the time to perform an appendectomy. Our case reviews the decision to place mesh for hernia repair, after performing appendectomy, and measures taken to limit infection. We have shown in this case that it is safe to place mesh even if the bowel is transected. …

Chiropractic Role In The Interdisciplinary Care Of A Patient With Low Back Pain Following Spinal Cord Infarction, Chloe Nilles Dc, Joseph Mehring Dc, Jessy Johnson Dc, Dacrb, Venkateswara Gogineni Phd, Eric Kirk Dc, Daco

Scientific Day

Introduction/Background:

Spinal cord infarction is a rare type of stroke that occurs within the spinal cord or the arteries that supply it. The etiology of spinal cord infarction is commonly a result of atherosclerosis and related complications. The outcome of this condition often results in severe disabilities and functional impairment. The focus of long-term management is on rehabilitation to optimize function and quality of life. This case report highlights how a chiropractor functioned within an interdisciplinary healthcare team to manage low back pain in a patient with a history of spinal cord infarction.

Description:

A 46-year-old male with a history …

A Rare Case Of Primary Breast Merkel Cell Carcinoma In A Male Gendered Patient, Sydney A. Pekarek Do, Archana Chandrashekar Do, M Bassel Attasi Md, Emily E. Klosterman Do, Joslyn Albright Md

Scientific Day

Introduction/Background:

Merkel cell carcinoma (MCC) is an aggressive, rare neuroendocrine tumor, typically arising in the skin. However, there are few documented cases of neuroendocrine tumors of breast parenchyma with Merkel cell differentiation. This accounts for less than 0.1% of all breast cancers with almost all cases being described in females.

Description:

We present here a 62-year-old, immunocompetent, Hispanic male with a palpable and painful right sided breast mass, present for three to four months. On the exam, a four-centimeter mass was palpated in the 9 o’clock region of the right breast without associated skin nodularity or dermal attachment. Diagnostic mammography …

From Dyspnea To Recovery: Multidisciplinary Management Of Hormonal Contraceptive-Associated Pe In An Adolescent, Christopher Bentsen Md, Viktoriya Bikeyeva Md, Giovanni Paolella Md, Suhaib M. Hyder Md, Kelsey Danley Md, Neal Sawlani Md, Ibrahim Shaik Md

Scientific Day

Introduction/Background:

The incidence of pulmonary embolism (PE) in hospitalized children is rare, with only 56 per 100,000 patients affected, predominantly females. Although rare, the use of hormonal contraceptives (HC) in adolescent females is linked to 79% of all venous thromboembolism (VTE) and PE cases. This risk is further doubled when using transdermal HC compared to oral. This case highlights the importance of recognizing the life-threatening hypercoagulable side effects of HC in adolescent women, particularly when symptoms may mistakenly be attributed to benign causes.

Description:

A 17-year-old female with no medical history presented with a two-week history of pleuritic chest pain …

Mystery Stalk: Thrombus Or Myxoma, Steven Jacobsen Do, Giovanni Paolella Md, Christopher Bentsen Md, Carson Discher Md, Rafia Ali Md, Andrii Labchuk Md, Kelsey Danley Md, Marianna Krive Md, Neal Salwani Md

Scientific Day

Introduction/Background:

Left atrial (LA) masses in patients with new onset atrial fibrillation (AF) are uncommon but clinically consequential findings. Differentiating between LA thrombus and myxoma is critical in determining proper management, which may include anticoagulation, cardioversion, and/or surgery. While cardiac magnetic resonance imaging (cMRI) is considered the gold standard for tissue characterization, overlap in imaging features may limit diagnostic certainty in select cases. This case highlights management options when the gold standard fails to provide a definitive diagnosis.

Description:

A 74-year-old woman with HFpEF presented with chest pain and dyspnea and was admitted with new onset atrial fibrillation with RVR. …

A Heart-Stopping Decision: An Ethical Dilemma Involving Pacemaker Deactivation At End Of Life, Hailee Grannan Md, Nora Badi Md, Kavita Sharma Md

Scientific Day

Introduction/Background:

Pacemaker deactivation at the end of life presents complex ethical and logistical challenges. While Heart Rhythm Society affirms a patient’s right to withdraw life-sustaining treatments, clinicians often experience moral distress when patients are pacemaker-dependent. Unlike defibrillators, pacemakers are perceived as integral to the body rather than external interventions, leading to concerns regarding hastening of death with pacemaker deactivation. In this case, we highlight how device manufacturer procedural requirements can also create obstacles to deactivation, resulting in unintended prolonged suffering and increased distress for the patient and family.

Description:

A 74-year-old male with metastatic renal cell carcinoma developed third-degree heart …

Increasing Utilization Of The Tyrer-Cuzick Score To Improve Breast Cancer Risk Assessment In Primary Care, Lindsay Sawyer Do, Megan Matre Md, Katharine Kelly Md, Lisa Sullivan-Vedder Md

Scientific Day

Background/Significance:

The Tyrer-Cuzick (T-C) score is a risk prediction tool used to provide a quantitative estimate of an individual's lifetime risk of developing breast cancer and can be used to guide screening practices. A high score may lead to recommendations for earlier breast imaging, lifestyle modifications, genetic testing, risk reducing medications or surgery. Given updated recommendations by professional organizations such as the American Academy of Breast Surgeons, Advocate Health developed Primary Care and Radiology workflow processes to attempt to standardize breast cancer risk assessment. Since initiating this workflow in July 2023, there has been a disproportionate number of patients screened …

Staging Laparoscopy For Pancreatic Ductal Adenocarcinoma: Experience From A Large Quaternary Care System, Mary Brandt Md, Astrid Levesque Bs, Rebecca Kirschner Md, Geoffrey Bellini Md, Wesley Papenfuss Md, Dawn Wankowski Ms

Scientific Day

Background/Significance:

Detection of radiographically occult metastatic disease (ROMD) in pancreatic ductal adenocarcinoma (PDAC) remains vital for staging. There is no standardized approach, but borderline resectable or locally advanced disease, CA 19-9 > 394, location in the pancreatic body or tail, and no neoadjuvant therapy are predictive of ROMD and often used to select patients for staging laparoscopy. Peritoneal washings have been used at the time of laparoscopy to further detect occult disease, with positive cytology considered by NCCN guidelines to be metastatic (M1) disease.

Purpose:

We sought to study characteristics of patients undergoing laparoscopy with or without washings to inform a …

Balancing Safety And Quality With End-Of-Life Realities: A Single Inpatient Hospice Facility Review, Hailee Grannan Md, Sarah Riutta Phd, Kavita Sharma Md

Scientific Day

Background/Significance:

Patient safety in hospice care requires balancing traditional safety metrics with individualized, comfort-focused goals at the end of life. Inpatient hospice units manage complex symptoms, high-risk medications, and dynamic family preferences, yet limited literature characterizing safety events in this setting. Despite routine event reporting, no comprehensive evaluation of safety incidents has been conducted at Zilber Family Hospice (ZFH).

Purpose:

The purpose of this project was to characterize and analyze patient safety incidents at ZFH to identify patterns, clarify event categorization, and inform hospice-specific safety practices and staff education that support comfort and harm reduction.

Methods:

Safety incidents at ZFH …

The Effectiveness Of Implementation Of A Point Of Care Ultrasound Curriculum For Pediatric Residents, Ashley Anderson Do, Peyton Cleary Do, Claudia Zarcula Do, Karan Patel Do, Elizabeth Price Do, Jacob R. Hutton Md

Scientific Day

Background/Significance:

Point of Care Ultrasound (POCUS) is a useful diagnostic and therapeutic tool in the inpatient and emergency department settings. Pediatric residency programs across the United States have failed to incorporate POCUS training into their curricula despite strong resident interest.

Purpose:

Currently, pediatric residents at Advocate Children’s Hospital – Park Ridge does not receive POCUS training. Thus, we sought to institute a POCUS curriculum to address that training gap.

Methods:

Residents took a 15-question examination via Google Forms to assess baseline knowledge of POCUS. Over the course of 4 weeks, residents received four separate lectures given by POCUS trained pediatric …

Age-Specific Patterns Of Chlamydia Screening And Positivity In The Absence Of Electronic Health Record Prompts: Variation By Specialty And Social Vulnerability, Madison Kob, John Brill Md, Mph

Scientific Day

Background/Significance:

Chlamydia trachomatis (CT) remains one of the most reported bacterial sexually transmitted infections in the United States, disproportionately affecting young women. National guidelines recommend annual screening of sexually active women under the age of 25 to reduce risks of pelvic inflammatory disease and comparable conditions. However, operationalizing risk-based screening within the Electronic Health Record (EHR) proves challenging when sexual activity is not comprehensively documented. During a period without active EHR prompts in Aurora St. Luke’s integrated health system, baseline CT screening patterns were evaluated to inform future workflow and quality initiatives.

Purpose:

To characterize age-specific CT screening and positivity …

Missed Opportunities: Sex Disparities In Dexa Screening Among Cancer Patients Receiving Hormonal Therapy, Faiz Hussain Md, Pooja Bhatt Md, Logan Daines Do, Magdalena Flejsierowicz Md, Dawn Wankowski Ms, James O. Adefisoye Phd

Scientific Day

Background/Significance:

Bone health complications are a well-recognized but often under-monitored consequence of androgen deprivation therapy (ADT) and aromatase inhibitor (AI) therapy, which accelerate bone mineral density loss and increase fracture risk. Despite guideline recommendations from NCCN and ASCO for baseline and periodic DEXA screening, adherence remains low across multiple real-world studies. However, institution-specific adherence patterns, particularly potential sex-based disparities remain poorly characterized.

Purpose:

To evaluate adherence to guideline-recommended DEXA screening and assess sex-based differences among patients with non-metastatic breast or prostate cancer receiving hormone therapy within Advocate Health Midwest Wisconsin locations.

Methods:

We conducted a retrospective review of patients diagnosed …

Evaluation Of The Adherence To Established Guidelines For Labor Arrest Disorders In Nulliparous, Term, Singleton, Vertex Cesarean Births, Laurel Pietrzak Do, Sarai Trenhs Do, Manuel Lamptey Ms, Jessica Jf Kram Mph, Callie Cox Bauer Do

Scientific Day

Background/Significance:

The Nulliparous, Term, Singleton, Vertex (NTSV) cesarean birth rate was developed as a quality metric to provide a standardized way of evaluating rates between hospitals with the aim of reducing primary cesarean rates. Currently, in the United States NTSV cesareans account for ~25.6% of births (national benchmark 23.6%). Labor arrest disorders, including failed induction of labor, arrest of cervical dilation, and arrest of fetal descent, account for ~18-35% of primary deliveries, making them one of the more common indications for NTSV cesareans. However, there has been limited evaluation of adherence to American College of Obstetricians and Gynecologists (ACOG) Safe …

Understanding Patient Experiences And Diagnostic Challenges In Long Covid Care, Raegan King Mph, Tiffany Ford Phd, Mph, Osondi Osondi-Lohrer Ms, Ccrp, Jana Hirschtick Phd, Mph

Scientific Day

Background/Significance:

Long COVID is characterized by persistent, heterogeneous symptoms that often lack timely recognition, contributing to delayed diagnosis and fragmented care. Understanding patient experiences with diagnosis and care pathways is critical to determining whether and how receiving a Long COVID diagnosis influences access to care, patient well-being, and perceptions of validation within the healthcare system. This study aimed to explore patient experiences with a Long COVID diagnosis and care navigation within the Advocate Health system, with a focus on identifying barriers to diagnostic equity and opportunities to improve clinical pathways.

Purpose:

The purpose of this study was to understand diagnostic …

Population Health "Pop Spotting", Glenda Sundberg Fnp-Cs, Apnp, Zeeshan Yacoob Md, Mph, Stephenie Quirke Do, Devanshi Patel Do, Tien Vo Bs,Ba

Scientific Day

Background/Significance:

Various gaps persist across communities due to barriers that prevent patients from accessing their healthcare needs. Aurora St. Luke’s Family Practice Clinic, which serves a diverse and underserved population, developed an interdisciplinary outreach model called “Pop Spotting”

Purpose:

We aim to create a model that allows the clinic team to identify patients who have multiple care gaps and have been lost to follow up. By reaching out to these patients and scheduling visits, we hope to meet health care needs efficiently and improve patient outcomes.

Methods:

This project utilizes Population Health Indicator (PHI) scores to identify established clinic patients …

Yentl Syndrome Refuted: Cholesterol Management From A Multicenter Healthcare System, Anya Lei Koza Do, Venkateswara Gogineni Phd, Tanvir Bajwa Md, Suhail Allaqaband Md, David Boulware Ms, M Fuad Jan Md

Scientific Day

Background/Significance:

According to the GOULD registry, the median low-density lipoprotein (LDL) after coronary revascularization is 99mg/dL. Similarly, a large-scale New York City health system cohort (2018-2023) reports 52% of those who underwent revascularization had a median follow-up LDL<70 mg>/dL.

Purpose:

Our retrospective study assesses the current practices of cholesterol-lowering therapy and secondary risk reduction strategies for patients who have undergone percutaneous intervention or coronary artery bypass grafting from September 2011 to September 2023 across all 25 Advocate Aurora Health medical centers in Wisconsin and Illinois.

Methods:

Among the 42,561 identified patients, 20,501 were excluded because of incomplete data. The primary …

Comparison Of Dosing Strategies Of Levetiracetam For Seizure Prophylaxis In Patients With Traumatic Brain Injury, Aya Alwan Pharmd, Andrew Mcinerney Pharmd, Bcemp, Lina Piech Pharmd, Bcps, Bcccp

Scientific Day

Background/Significance:

Traumatic brain injury (TBI) affects around 1.7 million individuals annually in the United States and is associated with detrimental complications including seizures. Anticonvulsants are used prophylactically, with the 2024 Neurocritical Care Society Clinical Practice Guideline recommending levetiracetam as the preferred agent. However, no standardized dosing strategies currently exist, resulting in variability in both loading and maintenance of dose regimens across institutions and among providers. The aim of this project is to identify the most appropriate dosing strategy of levetiracetam to reduce seizure incidence in patients with TBI.

Purpose:

This project aimed to identify the most appropriate dosing strategy of …

The Rhythm Of Sedation: Comparison Of Methohexital, Propofol, And Etomidate For Ed Cardioversions, Maria Hajiharis Pharmd, Ami Shah Pharmd, Andrew Mcinerney Pharmd, Bcemp

Scientific Day

Background/Significance:

Cardioversions in the emergency department (ED) allow for a controlled shock to be delivered to the heart to restore normal sinus rhythm in dysrhythmic states such as atrial fibrillation and supraventricular tachycardia. Sedation used during this procedure helps to reduce anxiety, pain, and discomfort. There are several general anesthetics available, and those with a quick onset and recovery time with minimal side effects are favorable. Current data is limited, with one retrospective review by Bauer and colleagues comparing methohexital to propofol and etomidate for procedural sedation in ED cardioversions finding no statistically significant difference in the time from first …

Evaluating The Effectiveness Of Magnesium In Addition To Prochlorperazine For The Treatment Of Migraines In The Emergency Department, Michael Cirone Md, Thomas Szwajnos Pharmd, Samar Ashrafi Pharmd, Ryan Mckillip Md, Kara Fifer Pharmd, Cathrine Roels Pharmd, Nadine Lomotan Pharmd, Cindy Ndiaye Mph, Travis Hase Md, Loredana Huma Phd, Acrp-Cp

Scientific Day

Background/Significance:

Clinical practice guidelines for the acute management of migraines recommend antiemetics such as prochlorperazine as first-line therapy. Although intravenous (IV) magnesium sulfate (Mg) has demonstrated benefit as a standalone treatment for acute migraines, whether it can provide additive analgesic benefit when combined with prochlorperazine is unknown.

Purpose:

Determine whether IV Mg combined with prochlorperazine provides greater reduction than prochlorperazine monotherapy in emergency department (ED) patients with acute migraine.

Methods:

This prospective, double-blind, randomized controlled trial compares IV prochlorperazine and Mg with prochlorperazine and placebo in patients presenting the ED with symptoms of acute migraine. All participants received IV diphenhydramine …

Language-Related Differences In Prenatal Depression Screening, 2019-2024, Amanda Luff Phd, Anne Rivelli Mph, Ma, Akaninyene Noah Mph, Emily Malloy Phd, Cnm, Facnm, Ravi Mishra Md, Veronica Fitzpatrick Drph, Mph

Scientific Day

Background/Significance:

The American College of Obstetricians and Gynecologists issued its first recommendation for universal prenatal depression screening (PDS) in 2015 and reinforced this opinion in 2018. In 2019, the National Committee for Quality Assurance added Prenatal Depression Screening and Follow-up as a quality measure. Language can be a barrier to receipt of recommended screenings.

Purpose:

To evaluate how language preference was associated with uptake of PDS following updated recommendations.

Methods:

This retrospective cohort included people who received prenatal care (PNC) for delivery at an Advocate Midwest facility between 2019 and 2024. We identified PDS through the presence of a depression …

Combination Therapy Versus Monotherapy And The Risk Of Diabetic Ketoacidosis Among Patients On Sglt2 Inhibitors And Glp-1 Receptor Agonists, Chimezirim Ezeano Md, Mph, Ekow Essien Md, Rodolfo Alpizar-Rivas Md, Fccp

Scientific Day

Background/Significance:

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) reduce cardiovascular and renal events but carry a recognized risk of diabetic ketoacidosis (DKA), including euglycemic presentations. Whether combining SGLT2i with glucagon-like peptide-1 receptor agonists (GLP-1RA) modifies DKA risk compared with monotherapy remains unclear. We evaluated 1-year DKA risk among adults with type 2 diabetes treated with combination therapy versus either agent alone.

Purpose:

To compare the 1-year incidence and hazard of DKA across three treatment strategies: (1) SGLT2i + GLP-1RA vs GLP-1RA alone; (2) SGLT2i + GLP-1RA vs SGLT2i alone; and (3) SGLT2i alone vs GLP- 1RA alone.

Methods:

We conducted a retrospective multicenter …

Vibrating Mesh Vs. Jet Nebulizers For High-Dose Albuterol In Copd Exacerbations: A Non-Inferiority Study, Laura Reindl Ms, Rrt-Accs, Rrt-Nps, Sarah Bazelak Msc, Kristen Knox Rrt, Shanna Schuele Msc, Katlin Huizenga Rrt, Malik Hodges Rrt, Kimberly Parker Rrt, Jennifer Lester Pharmd, Sadashiv Santosh Md

Scientific Day

Background/Significance:

Inhaled β-agonists are central to the management of COPD exacerbations, and high-dose albuterol is often administered via jet nebulizer (JN) to ensure adequate bronchodilation. Vibrating mesh nebulizers (VMNs) may enhance aerosol delivery efficiency and substantially reduce treatment time compared to JNs, but evidence comparing these devices for high-dose therapy in COPD exacerbations remains limited.

Purpose:

This quasi-experimental, before-and-after non-inferiority study evaluated clinical outcomes associated with transitioning from continuous JN to VMN delivery of high-dose albuterol in the emergency department (ED).

Methods:

This institutional review board–approved study was conducted in the ED of a tertiary care hospital. Historically, high-dose albuterol …

Predischarge Ct Does Not Impact Detection Rate Of Postoperative Pancreatic Fistula After Distal Pancreatectomy: A Community Quaternary Experience, Ruby Armstrong Bs, Areej Sami Md, Manuel Lamptey Ms, Kristen Kolberg Md, Mary Brandt Md, Sarah Riutta Phd, Geoffrey Bellini Md, Wesley Papenfuss Md

Scientific Day

Background/Significance:

Post-operative pancreatic fistula (POPF) remains a challenging complication after distal pancreatectomy (DP). CT scan is commonly used to evaluate postop fluid collections/ POPF. We sought to identify predictive factors of POPF in our post-operative cohort with focus on patients who underwent post-operative CT due to suspicion for fistula at our institution.

Purpose:

The primary objective of this study was to evaluate the rate of POPF in all DP patients, and POPF in DP patients with negative post-operative CT (NegCT). We hypothesized that BMI (>30) would increase risk of NegCT in setting of POPF. The secondary objective of this …

How Soon Is Too Soon? The Association Between Observation Time Off Supplemental Oxygen And Readmission Rates For Infants Hospitalized With Bronchiolitis, Lauren Amendola Do, Faap, Emma Flosi Do, Matthew Silas Do, Loredana Huma Phd, Acrp-Cp, Hasan Mahbubul Ms, Msis, Sheena Mckenzie Md, Mba, Faap

Scientific Day

Background/Significance:

High-flow nasal cannula and low-flow nasal cannula are widely used in bronchiolitis, the leading cause of infant hospitalization. Limited evidence informs optimal duration of monitoring after discontinuing oxygen before discharge, resulting in wide practice variation.

Purpose:

Our primary objective was to determine if the duration of monitoring patients with bronchiolitis off supplemental oxygen before discharge was associated with differences in 7- and 30-day emergency department (ED) visit or hospital readmission rates. Our secondary objective was to assess how the following characteristics are associated with observation time off oxygen: age, prematurity, last oxygen modality used, viral pathogen, time of oxygen …

Atrial Tachycardia Reduction With Intravenous Use Of Magnesium (Atrium), Ryan Mckillip Md, Samar Ashrafi Pharmd, Haneen Hussein Pharmd, Travis Hase Md, Kara Fifer Pharmd, Cathrine Roels Pharmd, Nadine Lomotan Pharmd, Cindy Ndiaye Mph, Loredana Huma Phd, Acrp-Cp, Marc Mcdowell Pharmd

Scientific Day

Background/Significance:

Magnesium sulfate (Mg) is a safe and effective option for the management of atrial fibrillation or atrial flutter with rapid ventricular response (AFF RVR); however, the optimal dose is unknown. Prior research on its effectiveness has primarily used high-dose regimens (4-9g), which are associated with increased adverse effects, such as hypotension and bradycardia. Whether lower doses can provide comparable rate-control benefit while reducing adverse events is unknown.

Purpose:

The objective of this study is to compare the efficacy of lower doses of intravenous (IV) Mg to successfully decrease the ventricular rate to under 120 beats per minute (bpm) in …

Examining Attitudes Towards Ai Tools In Graduate Medical Education And Healthcare Practice, Mahbubul Hasan Ms, Msis, Sarah Riutta Phd, Ryan Mckillip Md, Jill Patton Do, Alonzo Jalan Md

Scientific Day

Background/Significance:

Artificial intelligence (AI) tools are rapidly being introduced into clinical and research workflows, including documentation support, data analysis, and decision augmentation. Successful integration of these tools will depend on user trust, perceived appropriateness, and ethical comfort. Misalignment between institutional implementation strategies and frontline clinician attitudes may influence adoption, safe use, and long-term impact on patient care and research integrity. However, little is known about how health system–affiliated clinicians, educators, and researchers perceive AI use across professional roles and training levels. To this end, we conducted a survey-based study to gather information on how AI tool use is perceived by …

The Creation And Assessment Of A Novel Faculty Development Program: Scholarship And Collaboration For Hospitalist Learners In Research (Scholar), Melanie Marsh Md, Ryan Wolf Md, Elizabeth Halvorson Md, Ms, Sheena Mckenzie Md, Mba, Faap

Scientific Day

Background/Significance:

With the rapid growth of Pediatric Hospital Medicine (PHM) and the growing number of PHM fellows requiring scholarship oversight, there is a critical need for PHM faculty who can supervise fellows in the execution of scholarly requirements. However, variation exists in faculty skill sets and available training for PHM fellows.

Purpose:

We developed and implemented a 1-year research program for fellows and junior faculty grounded in the four pillars of Boyer’s Model of Scholarship. Scholarly productivity and self-reflective, behavior-based assessments were evaluated before and after the program.

Methods:

A needs assessment of PHM faculty at four children’s hospitals within …

Evaluating Adherence To Fetal Heart Rate Monitoring Guidelines As A Decision For Primary Cesarean Deliveries, Sarai Trenhs Do, Laurel Pietrzak Do, Manuel Lamptey Ms, Jessica Jf Kram Mph, Callie Cox Bauer Do

Scientific Day

Background/Significance:

Cesarean delivery rates in the United States remain high at ~32% of deliveries. Primary cesarean deliveries or Nulliparous, Term, Singleton, Vertex (NTSV) cesareans are ~26%. National benchmarks focus on reducing NTSV cesareans as a key strategy to addressing the overall cesarean delivery rate. While the NTSV benchmark (NTSV rate 23.6% or lower) is an important benchmark for quality improvement, it does not account for clinical factors that may influence delivery decisions. Non-reassuring fetal status (Category II or III) is a frequent indication for NTSV cesareans, yet it is inconsistently defined and fetal heart rate (FHR) monitoring guidelines (Clark guidelines) …

Latency After Preterm Pre-Labor Rupture Of Membranes (Pprom) And Outcomes At A Single Community Hospital, Ciera Danen Md, James O. Adefisoye Phd, Jessica Jf Kram Mph, Marie Forgie Do

Scientific Day

Background/Significance:

Preterm pre-labor rupture of membranes (PPROM, membrane rupture <37 weeks>gestation) is associated with increased morbidity/mortality. Guidelines recommend inpatient management until the risks of pregnancy outweigh the risks of neonatal prematurity under 34 weeks’ gestation. Latency, time from PPROM to delivery, varies from days to weeks secondary to potential maternal/fetal complications. ACOG cites that most people deliver within 7.0 days with latency inversely correlating with gestational age at the time of PPROM. However, this is based on an older study out of Israel that may not be generalizable in the US. Updated studies can improve counseling for estimated gestational age at …

Institutional Experience Of Concomitant Atrial Fibrillation Ablation And Left Atrial Appendage Occlusion, Hammam Shereef Md, Lynn Erickson Ms, Pmp, Gregory J. Fischer Bs, Jim Kanani Mph, Jasbir Sra Md

Scientific Day

Background/Significance:

Catheter ablation is a class 1 indication for treatment of symptomatic atrial fibrillation (AF). Left atrial appendage occlusion (LAAO) is an alternative option to anticoagulation in patients with AF and a contraindication to long-term anticoagulation. Combining catheter ablation and LAAO in a single procedure, referred to as the concomitant procedure, has emerged as a strategy for management of AF.

Purpose:

To assess the efficacy and safety of the concomitant procedure at a single center.

Methods:

In this retrospective observational study, data were collected on 28 patients who underwent LAAO with either the WATCHMAN FLX-PRO (n=26) or the Amplatzer Amulet …