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Articles 1 - 28 of 28
Full-Text Articles in Medicine and Health Sciences
Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig
Obstetrics Emergency Labor And Delivery Case Simulations With Normal Vaginal Delivery Demonstration: A Hands-On Simulation For Clerkship Students, Emily A. Young, William A. Winter, Robyn N. D'Agostino, Rose A. Maxwell, Sheela Barhan, Marilyn Kindig
Obstetrics and Gynecology Faculty Publications
Introduction: Simulation is rarely used for medical student education in the field of obstetrics. This method is an effective model of learning for topics that are encountered in clinical situations and for topics that pose significant risk to patients when an untrained individual is involved. Methods: A 2-hour obstetric delivery simulation session was developed and incorporated into the third-year obstetrics and gynecology clerkship rotation at Wright State University Boonshoft School of Medicine. Medical students completed self-guided content reviews with resources provided prior to the session. During the session, each medical student conducted a normal vaginal delivery and one of the …
Incidental Recognition Of Umbilical-Portal-Systemic Venous Shunt Diagnosed During Bpp For Decreased Fetal Movement, Kathleen Lundeberg, Adam Hiett
Incidental Recognition Of Umbilical-Portal-Systemic Venous Shunt Diagnosed During Bpp For Decreased Fetal Movement, Kathleen Lundeberg, Adam Hiett
Obstetrics and Gynecology Faculty Publications
Background: The prevalence of prenatally diagnosed umbilical-portal systemic venous shunts (UPSVS) is reportedly rare, ranging from 0.003-0.209% [1]. Disruption in the normal development of the fetal venous system can be caused by primary failure of a system or by secondary occlusion of an already transformed system [2]. While UPSVS’s are rare, the downstream effects are potentially fatal, including intrauterine growth restriction, high output cardiac failure, associated neonatal morbidity and mortality, and thus necessitate early detection with appropriate monitoring.
Introduction: The patient was a 21-year-old G2P1001 who presented to the Maternal Fetal Medicine Ultrasound Genetics (MFMUG) clinic at 36w2d for a …
Integrating An Evidence Based Medicine Module Presentation Into The Ob-Gyn Clerkship, Judith Mathess, Betsy Gauthier, Zenab Saeed, Ngozi Anachebe, Rose A. Maxwell, Jason C. Massengill, Marilyn Kindig
Integrating An Evidence Based Medicine Module Presentation Into The Ob-Gyn Clerkship, Judith Mathess, Betsy Gauthier, Zenab Saeed, Ngozi Anachebe, Rose A. Maxwell, Jason C. Massengill, Marilyn Kindig
Obstetrics and Gynecology Faculty Publications
Introduction: During the preclinical curriculum, students are introduced to EBM principles, however structured application to clinical medicine varies throughout clinical experiences. Application of EBM in a clinical educational environment affords students opportunities to practice required skills.
Methods: Students selected a patient case and formulated a question related to diagnosis ortreatment using the PICO framework. Students selected research publications related to the patient case, critically appraised their validity and generalization, and developed a comprehensive presentation involving a case summary and related EBM topics, which were evaluated by a faculty member using a rubric developed for the project. To assess the effectiveness …
Case Study: The Elusive Vaginal Leiomyoma, Fiona Hodges, Roziya Tursunova, Kelly Nagy, Halei Wong, Wright State University Boonshoft Som Department Of Obstetrics And Gynecology, Wright Patterson Air Force Base Department Of Obstetrics And Gynecology
Case Study: The Elusive Vaginal Leiomyoma, Fiona Hodges, Roziya Tursunova, Kelly Nagy, Halei Wong, Wright State University Boonshoft Som Department Of Obstetrics And Gynecology, Wright Patterson Air Force Base Department Of Obstetrics And Gynecology
Obstetrics and Gynecology Faculty Publications
This poster was presented at the September 2023 Armed Forces District Meeting.
A Case Of Spontaneous Adrenal Hemorrhage In Pregnancy, Benjamin Mallicoat, Kelly Nagy, Christopher Croom
A Case Of Spontaneous Adrenal Hemorrhage In Pregnancy, Benjamin Mallicoat, Kelly Nagy, Christopher Croom
Obstetrics and Gynecology Faculty Publications
A case study looking at a 25 year old patient at 31 weeks gestation with spontaneous adrenal hemorrhage.
Patient-Centered Focus Groups As A Catalyst For Anti-Racism Research And Quality Improvement In An Urban Academic Ob/Gyn Clinic, Samantha Brenner, Fiona Hodges, Tonia J. Rhone, Toni Tipton, Keith Reisinger-Kindle
Patient-Centered Focus Groups As A Catalyst For Anti-Racism Research And Quality Improvement In An Urban Academic Ob/Gyn Clinic, Samantha Brenner, Fiona Hodges, Tonia J. Rhone, Toni Tipton, Keith Reisinger-Kindle
Obstetrics and Gynecology Faculty Publications
Background •There is a known, pervasive existence of racism within OBGYN with resultant inequities and disparities in patient outcomes •Limited published perspectives of patients with racism in inpatient and outpatient OBGYN •The importance of centering patients’ voices in anti-racism research initiatives is clear •The objective of this study was to utilize patient-centered focus groups to prioritize anti-racism quality improvement and research investigations in the inpatient and outpatient setting
Vaginal Urinary Calculi Formation Secondary To Vaginal Mesh Exposure With Urinary Incontinence, Kara M. Griffiths, Geoffrey D. Towers, Jerome L. Yaklic
Vaginal Urinary Calculi Formation Secondary To Vaginal Mesh Exposure With Urinary Incontinence, Kara M. Griffiths, Geoffrey D. Towers, Jerome L. Yaklic
Obstetrics and Gynecology Faculty Publications
Background
Vaginal stones may form in the setting of mesh exposure with urinary incontinence. This report serves to help understand the presentation, evaluation, and management of vaginal urinary stones.
Case
A 68-year-old female presented with a vaginal calculus. She had a history of anterior and posterior polypropylene mesh placement for prolapse 7 years earlier and urinary incontinence. The stone was identified on a portion of exposed mesh and removed in office. Pathology confirmed urinary etiology. The exposed mesh resolved with topical estrogen. Cystourethroscopy excluded urinary fistula and bladder mesh erosion.
Conclusions
When identified, a vaginal calculus should be removed and …
Effect Of Continuous Local Anesthetic Use For Pain Control And Narcotic Use After Cesarean Section: A Randomized Trial, Jerome L. Yaklic, Rose Maxwell, Keira Urschel, S. Robinson, M. K. Dearmond, Steven R. Lindheim
Effect Of Continuous Local Anesthetic Use For Pain Control And Narcotic Use After Cesarean Section: A Randomized Trial, Jerome L. Yaklic, Rose Maxwell, Keira Urschel, S. Robinson, M. K. Dearmond, Steven R. Lindheim
Obstetrics and Gynecology Faculty Publications
Background: Post-operative pain control after Cesarean delivery is a major concern for both patients and physicians. The current literature provides mixed results on the effectiveness of the local continuous infiltration of anesthesia for pain control and reduction of morphine use. Methods: This was a randomized, double-blind, placebo controlled trial with a 1:1 group allocation. Fifty women who had a Cesarean delivery were randomly assigned to receive bupivacaine (Bupivacaine group) or saline (Saline group) delivered via locally placed catheters at the sub-fascial plane and at the uterine incision. Forty women (20 per group) completed the study. Total post-operative narcotic use and …
Trends In Management Of Overweight And Obesity In Obstetrics & Gynecology, Family Medicine And Pediatrics 2011-2015, Steven Lindheim, Stephanie Welsh, Nan Jiang, Amanda Hawkins, Lisa Kellar, Rose Maxwell, Leah D. Whigham
Trends In Management Of Overweight And Obesity In Obstetrics & Gynecology, Family Medicine And Pediatrics 2011-2015, Steven Lindheim, Stephanie Welsh, Nan Jiang, Amanda Hawkins, Lisa Kellar, Rose Maxwell, Leah D. Whigham
Obstetrics and Gynecology Faculty Publications
Purpose: To assess for improvement in the screening and management of overweight and obesity in the past 5 years among Obstetrician-Gynecologists (OB-GYN), Family Physicians (FP), and Pediatricians (Peds).
Methods: A retrospective pilot study was conducted, reviewing 150 charts of patients with overweight (body mass index [BMI] 25-29.9 kg/m2) and class I (BMI 30-34.9 kg/m2), class II (BMI 35-39.9 kg/m2), and class III obesity (BMI ≥ 40 kg/m2) between 2011 and 2015. Patients were from OB-GYN (n=50), Family Medicine, adult (FP-A) (n=50) and pediatric (FP-P) (n=28), and Peds (n=22) offices.
Results: 75% of patients were female; 35.5% had overweight, 40% had …
A Medical Malpractice Trial Where The Residents And Faculty Are The Judge And The Jury, Kelly A. Rabah
A Medical Malpractice Trial Where The Residents And Faculty Are The Judge And The Jury, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
At the conclusion of this session, the learner should be able to:
• Name 3- 5 of the most common reasons for a medical malpractice claim
• Describe and compare negligence, types of error, and recklessness
• Explain 3-5 steps that should be taken to minimize risk for a malpractice suit
• Discuss the emotional toll that litigation causes and the personal and professional risks that may result
Changing The Algorithm In The Evaluation Of Pelvic Anatomy In The Infertile Patient: Is Hysterosalpingo Contrast Sonography With Saline-Air Device The Appropriate Test For Everyone?, Kathryn Coyne, Thomas C. Winter, Rose Maxwell, Steven Lindheim
Changing The Algorithm In The Evaluation Of Pelvic Anatomy In The Infertile Patient: Is Hysterosalpingo Contrast Sonography With Saline-Air Device The Appropriate Test For Everyone?, Kathryn Coyne, Thomas C. Winter, Rose Maxwell, Steven Lindheim
Obstetrics and Gynecology Faculty Publications
The evaluation of the fallopian tubes is an essential part of the infertility workup, with abnormalities related to the fallopian tubes accounting for up to 40% of female subfertility.1 Laparoscopy is still considered the gold standard in the diagnostic evaluation of fallopian tubes, though the hysterosalpingogram (HSG) has long been recognized as complementary to laparoscopy, since tubal anatomy can be distinctly be seen.2 That said, previous investigations using laparoscopy as the gold standard demonstrate HSG has a sensitivity and specificity of 53% and 87%, respectively, for any tubal pathology and 46% and 95%, respectively, for bilateral tubal pathology.3
Residency And Fellow Participation In Root Cause And Intensive Analysis 2015-16, Kelly A. Rabah
Residency And Fellow Participation In Root Cause And Intensive Analysis 2015-16, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
The purpose of this document is to familiarize you with two processes that help with quality improvement known as a root cause analysis and an intensive analysis. Further, to explain your role in the process and the importance of your active participation.
Objectives:
• To understand the difference between a root cause and intensive analysis and be able to articulate when each would be appropriate.
• To learn about the importance of patient safety and quality through participation in these processes.
• To gain appreciation and insight into the importance of your role in examining medical and system errors as …
Transitions Of Care, Kelly A. Rabah
Transitions Of Care, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
Objectives:
• Define and Describe the various points of transition of care
• Define and Describe the potential risks for TOC
• Articulate the value of interdisciplinary team planning
• Demonstrate an effective patient hand-off via role play.
Infant Loss & Bereavement: A Journey For Families And Health Care Professionals, Kelly A. Rabah
Infant Loss & Bereavement: A Journey For Families And Health Care Professionals, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
Loss…
• Perinatal loss includes infertility during the preconception period, fetal death during pregnancy and infant death in the first year of life.
• Losing a wished-for child is startling and unexpected.
• Responses to this loss range from disappointment to life-changing anguish.
Common Living Situations With Older Patients: Balancing Support With Independence, Kelly A. Rabah
Common Living Situations With Older Patients: Balancing Support With Independence, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
Objectives:
1. Understand and discuss common challenges with aging patients that impact safety, independence and quality of life.
2. Describe how to assess for safety in living environment as well as what resources are available to support patient/family.
3. Know how to identify caregiver challenges, stress, and risk.
4. Understand the importance of addressing and documenting concerns and challenges, while being supportive and offering resources to promote QOL and Independence.
Medical Professionalism And Enculturation Of The Millennial Physician: Meeting Of The Minds, Steven R. Lindheim, Parvaneh K. Nouri, Kelly A. Rabah, Jerome L. Yaklic
Medical Professionalism And Enculturation Of The Millennial Physician: Meeting Of The Minds, Steven R. Lindheim, Parvaneh K. Nouri, Kelly A. Rabah, Jerome L. Yaklic
Obstetrics and Gynecology Faculty Publications
The conceptualization of medicine as a profession that was held to ethical and practical standards was first formalized through the writings of 18th century British physician-ethicists Gregory and Percival. This was in response to the lack of standardization in both training and practice that existed within medicine at the time. Percival’s Medical Ethics subsequently served as reference for the first Code of Medical Ethics issued by the American Medical Association (AMA) in 1847. Today, it is universally accepted that an important aspect of becoming a physician is the learning and implementing of high standards of medical professionalism into practice. …
The Changing Tides In Gynecologic Surgery Minimally Invasive Options: What We Know And How Do We Improve Use, Training, Michael L. Galloway
The Changing Tides In Gynecologic Surgery Minimally Invasive Options: What We Know And How Do We Improve Use, Training, Michael L. Galloway
Obstetrics and Gynecology Faculty Publications
Over the past twenty years gynecologic surgery has evolved from primarily abdominal approach to the current focus on minimally invasive surgical techniques. Minimally invasive techniques include vaginal and laparoscopic techniques. Evolution in laparoscopic technology and equipment has exploded to include multiple vessel sealing instruments of varying modalities, instruments with “wristed” capabilities and robotic assisted technology. Single port laparoscopy and natural orifice transluminal endoscopic surgery are other variations of laparoscopic technology.
Vaginal surgery is still touted as the “ultimate” minimally invasive surgery by ACOG; however, its use has not grown over this time. Many surgeons have had limited training in vaginal …
Creating An Exceptional Patient Experience, Kelly A. Rabah, Nada Elmagbari
Creating An Exceptional Patient Experience, Kelly A. Rabah, Nada Elmagbari
Obstetrics and Gynecology Faculty Publications
The patient's experience affects:
- Reimbursement
- Market Share
- Readmission
- Compliance
- Liability and M&M
Discussing Serious Illness, Kelly A. Rabah
Discussing Serious Illness, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
Objectives:
• Physicians will be able to describe and discuss the 5 times communication about serious illness is most likely to occur.
• Physicians will be able to list the criteria required to optimize delivery and outcomes of a patient/family meeting
• Physicians will participate in a clinical role play family meeting where difficult news is shared and explained in an OSCE Format. Feedback by Peers and Preceptor will be given.
• Physicians will be able to discuss proper documentation of pt./family communication, pt. decline, and supervision provided as well as the importance of continuous communication between the resident and …
Code Status Discussions, Kelly A. Rabah
Code Status Discussions, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
The 2 most Important Take-aways:
• Have the conversation early
• Fully disclose risks, benefits and alternatives
Quality Improvement Models, 2015: Wpafb, Kelly A. Rabah
Quality Improvement Models, 2015: Wpafb, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
Quality Improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used. We will look at some commonly used models in health care.
Detection Of The Dietary Xenoglycan N-Glycolylneuraminic Acid (Neu5gc) And Anti-Neu5gc Antibodies Within Reproductive Tracts Of Male And Female Infertility Subjects, Julie M. Sroga, Diana H. Wu, Fang Ma, Eilllen Tecle, Ilana B. Ressler, Rose Maxwell, Rachael Ferrari, Leah Whigham, Pascal Gagneux, Steven Lindheim
Detection Of The Dietary Xenoglycan N-Glycolylneuraminic Acid (Neu5gc) And Anti-Neu5gc Antibodies Within Reproductive Tracts Of Male And Female Infertility Subjects, Julie M. Sroga, Diana H. Wu, Fang Ma, Eilllen Tecle, Ilana B. Ressler, Rose Maxwell, Rachael Ferrari, Leah Whigham, Pascal Gagneux, Steven Lindheim
Obstetrics and Gynecology Faculty Publications
Objective
To assess the frequency of dietary xenoglycanNeu5Gc and antibodies in males and females and its impact on fertility.
Design
Prospective study of semen, uterine lavage, and follicular fluid from subjects undergoing infertility evaluation or in vitro fertilization (IVF) and fertile controls.
Setting
University based infertility program.
Participants
Males (n=23) and females (n=27) undergoing semen analysis and saline infusion sonography as part of their diagnostic evaluation and 37 women undergoing IVF were compared to fertile male (n=15) and female (n=14) controls.
Intervention
Neu5Gc was measured by affinity purified antibody staining on Western blots, flow cytometry, and by high performance liquid …
Quality Improvement Models, 2015, Kelly A. Rabah
Quality Improvement Models, 2015, Kelly A. Rabah
Obstetrics and Gynecology Faculty Publications
Quality Improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used. We will look at some commonly used models in Health Care.
The Changing Tides In Gynecologic Surgery: Minimally Invasive Options What We Know And How Do We Improve Usage And Training, Michael L. Galloway
The Changing Tides In Gynecologic Surgery: Minimally Invasive Options What We Know And How Do We Improve Usage And Training, Michael L. Galloway
Obstetrics and Gynecology Faculty Publications
Over the past twenty years gynecologic surgery has evolved from primarily abdominal approach to the current focuson minimally invasive surgical techniques. Minimally invasive techniques include vaginal and laparoscopic techniques. Evolution in laparoscopic technology and equipment has exploded to include multiple vessel sealing instruments of varying modalities, instruments with “wristed” capabilities and robotic assisted technology. Single port laparoscopy and natural orifice transluminal endoscopic surgery notes are other variations of laparoscopic technology. Vaginal surgery is still touted as the “ultimate” minimally invasive surgery by ACOG, however, its use has not grown over this time. Many surgeons have had limited training in vaginal …
Challenges And Considerations In Optimizing Ovarian Stimulation Protocols In Oncofertility Patients, Kathryn Coyne, Makenzie Purdy, Kathleen O'Leary, Jerome L. Yaklic, Steven R. Lindheim, Leslie A. Appiah
Challenges And Considerations In Optimizing Ovarian Stimulation Protocols In Oncofertility Patients, Kathryn Coyne, Makenzie Purdy, Kathleen O'Leary, Jerome L. Yaklic, Steven R. Lindheim, Leslie A. Appiah
Obstetrics and Gynecology Faculty Publications
The scope of cancer treatment in women of childbearing age has changed in the last decade. Fertility preservation is no longer an afterthought but central to multi-disciplinary cancer treatment planning and should be addressed due to the cytotoxic effects of cancer therapy. However, oncology patients present as a unique treatment challenge as the physician must balance the urgency of fertility preservation with the risks of delaying cancer therapy. Controlled ovarian stimulation (COS) is routinely applied in assisted reproductive technology but can be contraindicated in women with estrogen-receptor-positive tumors. This paper reviews some of the challenges to consider when using COS …
Molecular Genetic Studies And Delineation Of The Oculocutaneous Albinism Phenotype In The Pakistani Population, Thomas J. Jaworek, Tasleem Kausar, Shannon M. Bell, Nabeela Tariq, Muhammad I. Maqsood, Asma Sohail, Muhammad Ali, Furhan Iqbal, Shafqat Rasool, Saima Riazuddin, Rehan S. Shaikh, Zubair M. Ahmed
Molecular Genetic Studies And Delineation Of The Oculocutaneous Albinism Phenotype In The Pakistani Population, Thomas J. Jaworek, Tasleem Kausar, Shannon M. Bell, Nabeela Tariq, Muhammad I. Maqsood, Asma Sohail, Muhammad Ali, Furhan Iqbal, Shafqat Rasool, Saima Riazuddin, Rehan S. Shaikh, Zubair M. Ahmed
Obstetrics and Gynecology Faculty Publications
Background: Oculocutaneous albinism (OCA) is caused by a group of genetically heterogeneous inherited defects that result in the loss of pigmentation in the eyes, skin and hair. Mutations in the TYR, OCA2, TYRP1 and SLC45A2 genes have been shown to cause isolated OCA. No comprehensive analysis has been conducted to study the spectrum of OCA alleles prevailing in Pakistani albino populations.
Methods: We enrolled 40 large Pakistani families and screened them for OCA genes and a candidate gene, SLC24A5. Protein function effects were evaluated using in silico prediction algorithms and ex vivo studies in human melanocytes. The effects of splice-site …
Reducing Emergency Births By Modification In Oxytocin Utilization, Gary Ventolini, Michael L. Galloway, Sheela M. Barhan, Marc R. Belcastro
Reducing Emergency Births By Modification In Oxytocin Utilization, Gary Ventolini, Michael L. Galloway, Sheela M. Barhan, Marc R. Belcastro
Obstetrics and Gynecology Faculty Publications
Background: The purpose of our study was to explore the correlation between the amount of oxytocin use and emergency vacuum, forceps, cesarean births and neonatal intensive care unit (NICU) response to fetal distress. In 2004, we restricted the criteria for oxytocin utilization for labor induction and augmentation.
Methods: This retrospective study was carried out at a large private university tertiary care hospital- affiliated, and included data from the years 2005 to 2007. We utilized hospital data from vital statistics, labor and delivery, central pharmacy and NICU. Information obtained included maternal characteristics, annual birth data, indication and numbers of emergency vacuum, …
Abnormal Placental Findings Associated With Non-Reassuring Fetal Monitoring And Excellent Neonatal Outcomes, Gary Ventolini, Shanthi Ramesh, Sheela M. Barhan, Ran Neiger
Abnormal Placental Findings Associated With Non-Reassuring Fetal Monitoring And Excellent Neonatal Outcomes, Gary Ventolini, Shanthi Ramesh, Sheela M. Barhan, Ran Neiger
Obstetrics and Gynecology Faculty Publications
Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a …