Female Urogenital Diseases and Pregnancy Complications Commons^™

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 included …

El Acceso Y Uso De Las Pruebas Genéticas Para La Detección Precoz De Enfermedades Congénitas En Mujeres Embarazadas En La Ciudad Autónoma De Buenos Aires En El Año 2017 \ The Access And Use Of Genetic Tests For Early Detection Of Congenital Diseases In Pregnant Women In The Autonomous City Of Buenos Aires In The Year 2017, Anna Anna Bauer

Independent Study Project (ISP) Collection

Las pruebas genéticas son una herramienta útil para la prevención y el diagnóstico de defectos congénitos en las mujeres embarazadas. Esta investigación explora el acceso y uso de estas pruebas para mujeres que residen en la Ciudad Autónoma de Buenos Aires en el año 2017. Se trata de un tema amerita una investigación porque la tecnología para hacer estudios genéticos todavía es algo novedosa. Además, a través de las pruebas genéticas es posible detectar si el feto tiene un alto riesgo para desarrollar un defecto congénito, el cual es una de las causas más importantes de la mortalidad prenatal y …

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 reduced beyond 36 …

Ureterovaginal Fistula Secondary To Retained Vaginal Foreign Body In A Young Girl, Anjum Bandarkar, Adebunmi O. Adeyiga, Eglal Shalaby-Rana

Radiology Faculty Publications

We present the case of a 13-year-old girl with a recurrent urinary tract infection, malodorous vaginal discharge, and urinary incontinence caused by a retained vaginal foreign body. The foreign body, an aerosol cap retained for over 2 years, resulted in the formation of a ureterovaginal fistula, an extremely rare complication. The critical value of ultrasound and magnetic resonance urography in delineating the foreign body, the fistulous tract, and the intraperitoneal urine leak is described. Through this unique diagnostic dilemma, we wish to highlight that the evaluation of persistent unusual urinary symptoms and vaginal discharge in a young girl must include …

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

Undergraduate Theses, Professional Papers, and Capstone Artifacts

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 …

The Postnatal Management Of Gestational Diabetes, Savannah Prodzinski

Physician Assistant Scholarly Project Posters

• Diabetes mellitus is growing substantially in our nation. Between its natural progression and effects on other body systems, this epidemic is costing us billions of dollars a year.

• Although gestational diabetes typically resolves after pregnancy, women who have had gestational diabetes in the past have a largely increased risk for the development of diabetes mellitus in the future.

• Several things contribute to the development of GDM and DM: decline in β-cell function, lower adiponectin levels and HgbA1C levels in the third trimester.

• Intervening during the critical time after delivery in women with gestational diabetes, will theoretically …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

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 conjugates.

RESULTS: …

Cardiovascular Disease Risk Factors And Left Ventricular Hypertrophy In Girls And Boys With Ckd., Rebecca L. Ruebner, Derek Ng, Mark Mitsnefes, Bethany J. Foster, Kevin Meyers, Bradley A. Warady, Susan L. Furth

Manuscripts, Articles, Book Chapters and Other Papers

Background and objectives: Prior studies suggested that women with CKD have higher risk for cardiovascular disease (CVD) and mortality than men, although putative mechanisms for this higher risk have not been identified. We assessed sex differences in (1) CVD risk factors and left ventricular hypertrophy (LVH), and (2) the relationship of left ventricular mass (LVM) with different measures of body size in children with CKD.

Design, setting, participants, and measurements: The study population comprised 681 children with CKD from the Chronic Kidney Disease in Children cohort, contributing 1330 visits. CVD risk factors were compared cross-sectionally by sex. LVH was defined …

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 many …

Drug-Induced Nutrient Depletion, Rodney Richmond

Faculty Research ​and Publications

No abstract provided.

Important Strategies For Effective Family Planning Counseling, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

No abstract provided.

Characterization Of Bacterial Pathogens Involved In Aerobic Vaginitis: Prevalence, Strain Characterization And Sequelae, Leslie A. Lafferty

Graduate School of Biomedical Sciences Theses and Dissertations

Aerobic vaginitis (AV) is a more recently defined infection that involves aerobic pathogenic bacteria that replace the normal flora of the vaginal tract. It is commonly mistaken for other vaginal infections, such as bacterial vaginosis (BV), because they share many common symptoms. AV leads to complications during pregnancy, such as premature delivery and amnion infection, and is diagnosed by indications that range from vaginal discharge to inflammation. Because this infection is difficult to diagnose differentially from other vaginal infections, it is important to determine what pathogens are involved in AV so that we may have the ability to detect them. …

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) had …

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.

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 birth weight …

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 2,000 occupants off …

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, en unas …

Intrahepatic Cholestasis Of Pregnancy With Severe Elevation Of Bile Acids In The Setting Of Acute Hepatitis C Infection, Megan L. Lawlor, Agatha S. Critchfield

Obstetrics and Gynecology Faculty Publications

Intrahepatic cholestasis of pregnancy (ICP) is a complication of pregnancy resulting in elevation of serum bile acid levels. ICP is often associated with underlying liver disease, including hepatitis C. Bile acids in relationship to the acute infection of hepatitis C virus have not yet been delineated in the literature. A 26-year-old gravida 4 para 2103 with dichorionic, diamniotic twin gestation and history of intravenous drug abuse developed ICP in the setting of acute hepatitis C infection. In addition to clinical symptoms of pruritus and right upper quadrant pain, she developed severe elevation in bile acids, 239 micromol/L, and transaminitis aspartate …

The Hormonal Regulation Of The Claudin Genes In The Ovary, Sean Gadson, April Binder, Kenneth Korach, Katherine Hamilton

All Master's Theses

The ovary is a dynamic organ that responds to many hormonal signals. When these hormonal signals are disrupted, ovarian dysfunction can occur. One such example is Polycystic Ovarian Syndrome (PCOS). PCOS patients suffer from high levels of testosterone. Excess testosterone may misregulate genes in the ovary and disrupt ovarian function. The Claudin (Cldn) 3 and Cldn11 genes have been shown to be regulated by androgens in the testis, while studies in ovarian cancer cells suggests a coregulatory mechanism for the expressions of Cldn3 and Cldn4 in the ovary. The objective of this study was to characterize the hormonal …

Análisis De Las Políticas Públicas De Prevención Del Cáncer De Cuello Uterino Vinculadas Al Control Del Virus Del Papiloma Humano (Vph) En Argentina / An Analysis Of Argentina’S Public Health Prevention Strategies Of Cervical Cancer Related To The Control Of The Human Papiloma Virus (Hpv), Caroline Seman

Independent Study Project (ISP) Collection

El objetivo general de este estudio es analizar las políticas públicas de prevención del cáncer de cuello uterino (CCU) basadas en la incorporación de nuevas tecnologías como el test de VPH (Virus del Papiloma Humano) y la vacuna contra el VPH en Argentina. Los objetivos específicos son 1) describir la implementación del test de VPH y la campaña de vacunación obligatoria contra el VPH como estrategias de prevención primaria del CCU a nivel nacional: 2) identificar los factores que las facilitan y las obstaculizan. El CCU es el segundo cáncer más diagnosticado en las mujeres de Argentina. Desde el año …

Does Music Therapy Reduce Anxiety Levels In End-Stage Renal Disease Patients Undergoing Hemodialysis?, Andrew C. Konopacki

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy reduces anxiety levels in end-stage renal disease patients undergoing hemodialysis.

STUDY DESIGN: Systematic Review of two randomized controlled trials and one crossover study published in English in 2008, 2012 and 2013, respectively.

DATA SOURCES: Two non-blind randomized controlled trials and one cross-over study were found via PubMed and EBSCOhost databases.

OUTCOMES MEASURED: Subjective Anxiety Levels were measured in ESRD patients undergoing hemodialysis pre and posttest via patient self-reporting. An anxiety level survey graded on a scale of 1-10 was used in the study by …

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 …

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 will …

She's Having A Baby And Cancer, Ashley Lewis

Capstones

In October 2011, Megan Harris, a 38-year-old high school teacher from Atlanta, Georgia, found out she was pregnant with a new addition to her happy family of three. But she didn’t know until three months later that she’d be planning a funeral rather than a nursery.

Comparison Of Older Urologic Patients' Perceptions And Nurses' Assessments Of Discharge Readiness, Elizabeth Dodge

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to explore older urological patients’ perceptions and clinical nurses’ assessments of discharge readiness. In addition, this study examined the difference among older urological patients’ perceptions and clinical nurses’ assessments of discharge readiness.

Design: A descriptive, comparative, cross-sectional design was used.

Methods: Convenience samples of older urological patients and clinical nurses were recruited from three surgical units. Data were collected using The Patient Readiness for Hospital Discharge and Nurse Readiness for Hospital Discharge questionnaires.

Results: Patients perceived low total discharge and personal status readiness for discharge. This was in contrast to 93.9% of …

Barriers For Immunization Against Hpv In Developing Countries (India), Sandhya Ghanta

Master's Theses and Doctoral Dissertations

Cervical cancer is one of the most common cancers in women. Incidence and mortality rates of cervical cancer are high in less developed and developing countries. In some countries, the acceptance of the HPV vaccine to prevent cervical cancer is low. Previous studies revealed that lack of awareness, income, and education were major barriers for accepting the HPV vaccine. Apart from the above-mentioned barriers, some socio-cultural barriers for accepting the HPV vaccine exist in less developed and developing countries. This study surveyed 250 women in India of age groups 18 years and above. The sample population for the study was …

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

Journal of Patient-Centered Research and Reviews

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 to: …

Polycystic Ovarian Syndrome, Tameka Todd

Nursing Student Class Projects (Formerly MSN)

The main goal of this project was to educate peers on the pathophysiology of a disease or disorder of choice. The topic to be discussed is Polycystic Ovarian Syndrome (PCOS). This topic was chosen based on personal interest in women’s health issues. PCOS is a metabolic disease affecting 5-10 percent of women of childbearing age (Morgan, 2013). Characteristics of PCOS include enlarged ovaries consisting of multiple small cysts surrounding the outer ovary, with unknown cause (Morgan, 2013). Leading to the ovaries producing an increased amount of androgen (male hormones) (Morgan, 2013).