Medical Specialties Commons^™

Abnormal Placentation With Placenta Accreta In A Post Ablation Pregnancy, Amanda Mirmanesh, Raechel Fockler, Woojin Chong

Rowan-Virtua Research Day

Placenta accreta spectrum (PAS) is a rare complication of pregnancy in which the placenta abnormally implants into, and in rarer cases, through the uterine wall which leads to increased maternal morbidity with risk of maternal mortality. PAS diagnosed at the time of delivery is associated with severe maternal morbidity largely due to elevated blood loss which can result in complications such as DIC and even maternal death. We present a case of a woman with PAS to reiterate the importance of close antepartum monitoring along with having a high suspicion for placenta accreta in a patient with risk factors, specifically …

Gestational Diabetes Among The South Asian Diaspora In The United States Of America: A Scoping Review, Anudeep Deevi, Mariam Sharobeem, Gabrianna Andrews, Rahul Ubrani, Venkateswar Venkataraman

Rowan-Virtua Research Day

Aim: The scoping review was conducted to review the current knowledge base regarding gestational diabetes mellitus (GDM) among South Asians in the United States. In addition, the review was meant to identify any gaps in knowledge, specifically about the current care received by South Asians as well as the associated adverse health outcomes.

Methods: A systematic search of PubMed, Web of Science, Embase, and Scopus was conducted. Key words ""gestational diabetes South Asians in the United States" were used as search terms. Search was restricted to U.S. articles published on or after 01/01/2013 with key words. Articles were screened by …

Association Of Maternal Biomarkers With Gestational Weight Gain And Pre-Eclampsia, Matthew Green, Xinhua Chen

Rowan-Virtua Research Day

Background: There is convincing evidence that excessive gestational weight gain (GWG), based on the Institute of Medicine’s (IOM) 2009 guidelines, increases the risk of both maternal and neonatal complications.1-6 Although the association between excessive GWG and pre-eclampsia is well-established, the reason why this association exists remains unclear.

Methods: Previously collected data from a cohort of pregnant women in Camden, NJ between the years of 1998-2007 was used to examine the association between maternal serum biomarkers (C-peptide, IGF-1, Insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR)) collected at entry (week 16) and 3rd trimester (week 28) and longitudinally assessed gestational …

Barriers To Doula Use In New Jersey After 2021 Medicaid Coverage Expansion, June Solow, Aashna Reddy, Natali Sharma, Jonathan Lewis

Rowan-Virtua Research Day

Background: Doulas are trained non-clinical professionals that provide continuous support to a pregnant mother from the prenatal to postpartum period. Presence of a doula has been shown to benefit both mother and newborn health.

Purpose: To determine what prevents doula utilization in New Jersey.

Methods: A review of the current literature about doulas, mothers, clinicians, and legislation in other states was conducted. This included qualitative and quantitative data gathered in the United States.

Results: The most significant barrier from both the mother’s and doula’s perspectives is cost. Besides cost, diversity and number of doulas is low. A major barrier to …

Pregnancy Outcome With In Vitro Fertilization-Embryo Transfer According To Age In Women With Diminished Oocyte Reserve (Dor) Using A Follicle Stimulating Hormone Receptor Up-Regulation Technique, Brooke Neumann, Jerome Check, Carrie Wilson, Michael Sobel, Jung Choe

Rowan-Virtua Research Day

Objective: About 18 years ago, one of the top IVF centers published a study and found that women with DOR did not have any live deliveries at any age in women with a day 3 serum FSH exceeding 18 mIU/mL. The failure to achieve a live delivery may have been related to the ovarian hyperstimulation regimen with possible down regulation of the FSH receptor needed to produce a key enzyme needed for successful implantation. The purpose of this 25-year retrospective review was to evaluate the efficacy of a specific type of mild stimulation referred to as the FSH receptor up-take …

The Vaginal Microbiome Post-Menopause And Urinary Tract Infections, Rifke Anolik, Julia Kiffel, Venkateswar Venkataraman

Rowan-Virtua Research Day

Background: Urinary Tract Infection (UTI) is a condition where pathogens invade the urinary tract and can travel up the urethra and into the bladder. UTIs occur more commonly in females compared to males and in the post-menopausal population this rate increases significantly. While these infections may be asymptomatic, they can also cause severe discomfort and lead to serious and even life threatening complications. Recent investigation into the vaginal microbiome has opened the doors to a possible mechanism behind the increased incidence of UTIs after menopause. Understanding the pathogenesis behind the increased risk of UTIs in the postmenopausal state will allow …

Ovarian Hemorrhagic Cyst In A 42-Year-Old Female Receiving Ivf, Aloysius Ibe, Francesca Dileonardo, Robin Lahr, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 42-year-old female who presented with lower abdominal/pelvic pain and diagnosed with an active hemorrhagic ovarian cyst after undergoing egg retrieval as part of in-vitro fertilization (IVF) treatment. The differential for abdominal pain in women is vast, but for this patient receiving IVF we had to consider ovarian hyperstimulation syndrome and ectopic pregnancy just to name a few examples. It is predictable that most women will suffer from a ruptured ovarian cyst at some point in their lifetime so long as they continue to menstruate.

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Osteoprogenitor-Gmp Crosstalk Underpins Solid Tumor-Induced Systemic Immunosuppression And Persists After Tumor Removal, Xiaoxin Hao, Yichao Shen, Nan Chen, Weijie Zhang, Elizabeth Valverde, Ling Wu, Hilda L Chan, Zhan Xu, Liqun Yu, Yang Gao, Igor Bado, Laura Natalee Michie, Charlotte Helena Rivas, Luis Becerra Dominguez, Sergio Aguirre, Bradley C Pingel, Yi-Hsuan Wu, Fengshuo Liu, Yunfeng Ding, David G Edwards, Jun Liu, Angela Alexander, Naoto T Ueno, Po-Ren Hsueh, Chih-Yen Tu, Liang-Chih Liu, Shu-Hsia Chen, Mien-Chie Hung, Bora Lim, Xiang H-F Zhang

Faculty, Staff and Students Publications

Remote tumors disrupt the bone marrow (BM) ecosystem (BME), eliciting overproduction of BM-derived immunosuppressive cells. However, the underlying mechanisms remain poorly understood. Herein, we characterized breast and lung cancer-induced BME shifts pre- and post-tumor removal. Remote tumors progressively lead to osteoprogenitors (OPs) expansion, hematopoietic stem cell dislocation and CD41− granulocyte-monocyte progenitor (GMP) aggregation. The tumor-entrained BME is characterized by co-localization between CD41− GMPs and OPs. OP ablation abolishes this effect and diminishes abnormal myeloid overproduction. Mechanistically, HTRA1 carried by tumor-derived small extracellular vesicles upregulates MMP-13 in OPs, which in turn induces the alterations in hematopoietic program. Importantly, these effects persist …

Maternal Attitudes, Adjustment, Health Behaviors, And Social Support Among Mothers Of Infants In The Neonatal Intensive Care Unit, Ryanne N. Schaad, Alexa Bonacquisti, Elizabeth Greco, Chloe Hriso

Research Day

Introduction: A growing body of research suggests that an infants’ admission to a neonatal intensive care unit (NICU) is associated with adverse maternal mental health outcomes. Maternal attitudes, adjustment to motherhood, social support, and health behaviors may be important modifiable factors that could improve quality of life and well-being among NICU mothers. The current study examined the relationships among maternal attitudes, adjustment to motherhood, health behaviors, social support, and psychological functioning in NICU mothers.

Methods: One hundred twenty-seven women were recruited from NICUs at three hospitals in the Philadelphia area and completed self-report measures while in the NICU. Descriptive analyses …

Outcomes Of The "Brca Quality Improvement Dissemination Program": An Initiative To Improve Patient Receipt Of Cancer Genetics Services At Five Health Systems., Erica M Bednar, Minxing Chen, Michael T Walsh, Amanda L Eppolito, Molly H Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Han Gill Chao, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Rebekah Krukenberg, Sandra B Jenkinson, Jennifer J Moore, Cassandra Garcia, Fatimaeliza Gonzalez, Towanna Murray, Linda D Nielsen, Brenda Ho, Megan Haas, Sarah B Greenzweig, Abby Anderson, Christina Johnson, Nichole A Morman, Elizabeth Bowdish, Emaline Wise, Julia N Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F De Gracia, Brooke Levin, Kristin Mattie, Kathryn Zarnawski, Molly Kalasinski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M Kennedy, Rachel A Paul, Michelle Bilbao, Maureen Romero, Rebecca L Carr, Jennifer M Siettmann, Anna K Vercruyssen, Kaycee Leon, Banu K Arun, Andrew V Grainger, David P Warshal, Erin Bowman, Timothy A Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H Lu

Oncology Articles

OBJECTIVE: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

METHODS: QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, …

The Impact Of Maternal Diabetes On Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For Fetal-Placental Development, Sheryl Choo, Barbra De Vrijer, Timothy R H Regnault, Hilary K Brown, Larry Stitt, Bryan S Richardson

Obstetrics & Gynaecology Publications

Introduction

We determined the impact of gestational diabetes (GDM) and pre-existing diabetes (DM) on birth/placental weight and cord oxygen values with implications for placental efficiency and fetal-placental growth and development.

Methods

A hospital database was used to obtain birth/placental weight, cord PO₂ and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA >34 weeks (N = 69,854). Oxygen saturation was calculated from the cord PO₂ and pH data, while fetal O₂ extraction was calculated from the oxygen saturation data. The effect of diabetic status on birth/placental weight and cord oxygen values …

Abortion Access And Medically Complex Pregnancies Before And After Texas Senate Bill 8, Whitney Arey, Klaira Lerma, Emma Carpenter, Ghazaleh Moayedi, Lorie Harper, Anitra Beasley, Tony Ogburn, Kari White

School of Medicine Publications

Objective: To evaluate how Texas health care professionals who care for patients experiencing medically complex pregnancies navigate abortion restrictions.

Methods: We conducted qualitative in-depth interviews with health care professionals across Texas who cared for patients with life-limiting fetal diagnoses or who had existing or developed health conditions that adversely affected pregnancy. We conducted the first round of interviews March-June 2021 and the second round of interviews January-May 2022 after the implementation of Texas Senate Bill 8 (SB8), which prohibited most abortions after detection of embryonic cardiac activity. We used inductive and deductive qualitative analysis to identify themes and changes in …

Erac (Enhanced Recovery After Cesarean): A Safer And More Efficient Recovery Protocol, Allison Deluca

Senior Honors Projects

No abstract provided.

Gestational Weight Gain And The Associated Perinatal Outcomes In Middle Eastern Women, Dana Rector, Zeynep Alpay-Savasan

Posters

Gestational Weight Gain (GWG) can impact perinatal outcomes for mothers and infants, especially if the mother gains inadequate or excessive weight during pregnancy. We hypothesized that Middle Eastern women would be more likely to gain inadequate weight, compared to the general population, resulting in adverse perinatal outcomes.

The Effects Of Bmi On The Development Of Radiation Cystitis Onset: A Pilot Study, Kelsa G. Kazyak, Bernadette Mm Zwaans

Posters

Radiation cystitis (RC) is a debilitating adverse side effect of pelvic radiation therapy. Despite advancements within the field of radiation oncology, the location of the bladder makes it difficult to avoid during radiation and approximately 5-10% of cancer survivors with a history of pelvic radiation are at risk. While RC is not common, the long-term effects can be crippling and we hope to provide more information on the risk factors to help survivors and inform clinicians.

Obstetric Outcomes Assessment For New Mainers, Brendan Prast, Christina T. Holt, Amy Haskins, Debra Rothenberg

Costas T. Lambrew Research Retreat 2023

Introduction

• 13% of Portland’s population in 2019 was recent immigrants

• Numbers have increased, with >350 asylum-seeking families (1500 individuals) in 2022 in Portland alone

• Maine Medical Center (MMC) provides obstetrical care for more newly arrived, non-English speaking patients

• Total deliveries in 2020, 2021 (6192) broke records at MMC

• New Mainers at Increased risk for health disparities due to: language barriers, low socioeconomic status and stressors from a history of trauma

Covid-19 Prevalence And Trends Among Pregnant And Postpartum Individuals In Maine By Rurality And Pregnancy Conditions, Charlie Grantham, Christina Ackerman-Banks, Heather Lipkind, Kristin Palmsten, Katherine Ahrens

Costas T. Lambrew Research Retreat 2023

Our study is the first to estimate prevalence of COVID-19 among pregnant and postpartum individuals for Maine, using data that captures both commercial and public insurance and examines differences by rurality, a known modifier of COVID-19 infections in the U.S. individuals.

The Maine Obstetric Medical Simulation (Momsim) Program Identifies And Categorizes Latent Safety Threats Across Rural Hospitals, Jeffrey Holmes, Leah Mallory, Micheline Chipman, Becky Hunt, Sarah Austin, Tracey E. Mcmillan, Emily Watson, Mainehealth

Costas T. Lambrew Research Retreat 2023

Objective: Combine in-situ simulation with an HFMEA framework to identify and categorize common system wide LST and opportunities to improve patient safety

Opensim-Based Musculoskeletal Modeling: Foundation For Interactive Obstetric Simulator, Bahador Dodge

Electrical & Computer Engineering Theses & Dissertations

The use of mathematical and computational models to understand complex biological systems, such as the human birth process, is a rapidly growing field in medicine. These models can be used to optimize and personalize medical treatments for individual patients, enhance training, and aid in educational efforts. While recent advancements in healthcare, particularly in obstetrics, have improved care for mothers and babies, studies and government reports indicate a rising rate of maternal mortality in the United States.

Despite this rising trend, there is a lack of detailed studies concerning the use of modeling and simulation to develop an interactive obstetrics simulator …

Outcomes Following Extracorporeal Membrane Oxygenation For Severe Covid-19 In Pregnancy Or Post Partum, John J Byrne, Amir A Shamshirsaz, Alison G Cahill, Mark A Turrentine, Angela R Seasely, Joe Eid, Caroline E Rouse, Michael Richley, Nandini Raghuraman, Mariam Naqvi, Yasser Y El-Sayed, Martina L Badell, Cece Cheng, James Liu, Emily H Adhikari, Soha S Patel, Erika R O'Neil, Patrick S Ramsey

Faculty, Staff and Student Publications

IMPORTANCE: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad.

OBJECTIVE: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US. Eligible patients included individuals who received care at one of the study sites, were diagnosed with SARS-CoV-2 infection during pregnancy or up to 6 weeks post partum by positive nucleic …

Outcomes Of The “Brca Quality Improvement Dissemination Program”: An Initiative To Improve Patient Receipt Of Cancer Genetics Services At Five Health Systems, Erica M Bednar, Minxing Chen, Michael T Walsh, Amanda L Eppolito, Molly H Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Han Gill Chao, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Rebekah Krukenberg, Sandra B Jenkinson, Jennifer J Moore, Cassandra Garcia, Fatimaeliza Gonzalez, Towanna Murray, Linda D Nielsen, Brenda Ho, Megan Haas, Sarah B Greenzweig, Abby Anderson, Christina Johnson, Nichole A Morman, Elizabeth Bowdish, Emaline Wise, Julia N Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F De Gracia, Brooke Levin, Kristin Mattie, Kathryn Zarnawski, Molly Kalasinski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M Kennedy, Rachel A Paul, Michelle Bilbao, Maureen Romero, Rebecca L Carr, Jennifer M Siettmann, Anna K Vercruyssen, Kaycee Leon, Banu K Arun, Andrew V Grainger, David P Warshal, Erin Bowman, Timothy A Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H Lu

Faculty, Staff and Student Publications

OBJECTIVE: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

METHODS: QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, …

P53 And Ovarian Carcinoma Survival: An Ovarian Tumor Tissue Analysis Consortium Study, Martin Köbel, Eun-Young Kang, Ashley Weir, Peter F Rambau, Cheng-Han Lee, Gregg S Nelson, Prafull Ghatage, Nicola S Meagher, Marjorie J Riggan, Jennifer Alsop, Michael S Anglesio, Matthias W Beckmann, Christiani Bisinotto, Michelle Boisen, Jessica Boros, Alison H Brand, Angela Brooks-Wilson, Michael E Carney, Penny Coulson, Madeleine Courtney-Brooks, Kara L Cushing-Haugen, Cezary Cybulski, Suha Deen, Mona A El-Bahrawy, Esther Elishaev, Ramona Erber, Sian Fereday, Aocs Group, Anna Fischer, Simon A Gayther, Arantzazu Barquin-Garcia, Aleksandra Gentry-Maharaj, C Blake Gilks, Helena Gronwald, Marcel Grube, Paul R Harnett, Holly R Harris, Andreas D Hartkopf, Arndt Hartmann, Alexander Hein, Joy Hendley, Brenda Y Hernandez, Yajue Huang, Anna Jakubowska, Mercedes Jimenez-Linan, Michael E Jones, Catherine J Kennedy, Tomasz Kluz, Jennifer M Koziak, Jaime Lesnock, Jenny Lester, Jan Lubiński, Teri A Longacre, Maria Lycke, Constantina Mateoiu, Bryan M Mccauley, Valerie Mcguire, Britta Ney, Alexander Olawaiye, Sandra Orsulic, Ana Osorio, Luis Paz-Ares, Teresa Ramón Y Cajal, Joseph H Rothstein, Matthias Ruebner, Minouk J Schoemaker, Mitul Shah, Raghwa Sharma, Mark E Sherman, Yurii B Shvetsov, Naveena Singh, Helen Steed, Sarah J Storr, Aline Talhouk, Nadia Traficante, Chen Wang, Alice S Whittemore, Martin Widschwendter, Lynne R Wilkens, Stacey J Winham, Javier Benitez, Andrew Berchuck, David D Bowtell, Francisco J Candido Dos Reis, Ian Campbell, Linda S Cook, Anna Defazio, Jennifer A Doherty, Peter A Fasching, Renée T Fortner, María J García, Marc T Goodman, Ellen L Goode, Jacek Gronwald, David G Huntsman, Beth Y Karlan, Linda E Kelemen, Stefan Kommoss, Nhu D Le, Stewart G Martin, Usha Menon, Francesmary Modugno, Paul Dp Pharoah, Joellen M Schildkraut, Weiva Sieh, Annette Staebler, Karin Sundfeldt, Anthony J Swerdlow, Susan J Ramus, James D Brenton

Faculty, Staff and Student Publications

Our objective was to test whether p53 expression status is associated with survival for women diagnosed with the most common ovarian carcinoma histotypes (high-grade serous carcinoma [HGSC], endometrioid carcinoma [EC], and clear cell carcinoma [CCC]) using a large multi-institutional cohort from the Ovarian Tumor Tissue Analysis (OTTA) consortium. p53 expression was assessed on 6,678 cases represented on tissue microarrays from 25 participating OTTA study sites using a previously validated immunohistochemical (IHC) assay as a surrogate for the presence and functional effect of TP53 mutations. Three abnormal expression patterns (overexpression, complete absence, and cytoplasmic) and the normal (wild type) pattern were …

Prenatal Screening Decision-Making Facilitated Through An Online Patient Education Module, Erin Atkinson

Dissertations and Theses (Open Access)

As recommendations for prenatal genetic screening are expanded to include patients with pregnancies at low risk for aneuploidy, there is a need to develop accessible mechanisms to promote informed decision-making about genetic screening. The use of patient decision aids has been shown to promote informed decision-making. UTHealth Houston has developed and implemented an online module for pre-test triage for genetic counseling and education of low-risk pregnant patients about genetic screening, called the Prenatal Genetic Education Program (PGEP).

Here, through a retrospective chart review, we characterize the use of PGEP to triage previously presumed low-risk patients to genetic counseling, and whether …

Impact Of Recent Abortion Legislation On Patient Trust In Healthcare Providers, Jasmine Tyson Ms

Dissertations and Theses (Open Access)

Trust is a key aspect of any patient-provider relationship as patients must rely on their healthcare providers (HCPs) to provide appropriate care and guidance, maintain confidentiality, and act in their best interests. Studies suggest that recent changes to abortion legislation have resulted in a loss of the patient-physician relationship, with individuals describing feelings of isolation and fear regarding safety and confidentiality, and many seeking information outside of the medical community. An anonymous survey was distributed among members of abortion support groups and advocacy organizations in the United States to assess how recent changes to abortion legislation may impact patient trust …

Perceived Utility Of Genetic Carrier Screening In A Diverse Patient Population, Jack A. Colleran

Dissertations and Theses (Open Access)

Carrier screening assesses whether an individual may carry variants in select genes associated with autosomal recessive and X-linked inheritance. Recent American College of Medical Geneticists (ACMG) guidelines call for utilization of expanded screening that analyzes carrier status for up to hundreds of conditions. In these guidelines, clinical utility is based on alterations to reproductive decision-making. However, clinical utility study cohorts cited by these guidelines were largely white, highly educated, of high income, and were often receiving preconception counseling. There is a lack of research on the perspectives of patients from diverse backgrounds, whose perceptions may be more reflective of those …

Integrating Human Papillomavirus Testing As A Point-Of Care Service Using Genexpert Platforms: Findings And Lessons From A Kenyan Pilot Study (2019–2020), Valerian Mwenda, Joan-Paula Bor, Mary Nyangasi, James Njeru, Sharon Olwande, Patricia Njiri, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Globally, cervical cancer is a major public health problem, with about 604,000 new cases and over 340,000 deaths in 2020. In Kenya, it is the leading cause of cancer deaths, with over 3,000 women dying in 2020 alone. Both the Kenyan cancer screening guidelines and the World Health Organization’s Global Cervical Cancer Elimination Strategy recommend human papillomavirus (HPV) testing as the primary screening test. However, HPV testing is not widely available in the public healthcare system in Kenya. We conducted a pilot study using a point of care (POC) HPV test to inform national roll-out.

Methods: The …

The Effects Of Natural Epigenetic Therapies In 3d Ovarian Cancer And Patient-Derived Tumor Explants: New Avenues In Regulating The Cancer Secretome, Aya Mohr-Sasson, Jigal Haas, Michal Sivan, Yoni Zehori, Rina Hemi, Raoul Orvieto, Arnon Afek, Jaron Rabinovici

Faculty, Staff and Student Publications

KEY MESSAGE: Menstruation of adolescent girls might be influenced by Covid-19 mRNA vaccine, however, the ovarian reserve estimated by AMH is not compromised.

BACKGROUND: Recent studies have suggested that the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine causes menstrual abnormalities which led to concerns regarding its influence on the reproductive system. This study aims to investigate the influence of the SARS-CoV-2 mRNA vaccine on gynecologic well-being and future fertility of adolescent girls.

METHODS: This is a prospective cohort study conducted at a university affiliated medical center between June and July 2021. Adolescent girls aged 12-16 years who were vaccinated …

Effect Of Quality Of Life On Radiation Adherence For Patients With Cervical Cancer In An Urban Safety Net Health System, Alison K Yoder, Elizabeth Dong, Xiaoman Yu, Alfredo Echeverria, Shelly Sharma, Jane Montealegre, Michelle S Ludwig

Faculty, Staff and Students Publications

PURPOSE: Outcomes for patients undergoing chemoradiation for cervical cancer are dependent on adherence to radiation therapy (RT). In other diseases, quality of life (QoL) is associated with treatment adherence, but the association between QoL and RT adherence for patients with cervical cancer remains unclear.

METHODS AND MATERIALS: This prospective study included patients undergoing RT for cervical cancer from 2017 to 2021 at an urban safety net hospital. The Functional Assessment of Cancer Therapy-Cervical Cancer Version 4 was used to assess QoL based on 5 subscales (physical, functional, social and emotional, and cervical-cancer specific). The survey was administered at radiation consult, …

Advances In The Management Of Menopausal Symptoms, Fertility Preservation, And Bone Health For Women With Breast Cancer On Endocrine Therapy, Matteo Lambertini, Luca Arecco, Terri Lynn Woodard, Audrey Messelt, Kristin E Rojas

Faculty, Staff and Students Publications

In patients with hormone receptor-positive early-stage breast cancer, adjuvant endocrine treatment administered for up to 5-10 years after diagnosis significantly reduces the risk of recurrence and death. However, this benefit comes with the cost of short- and long-term side effects that may negatively affect patients' quality of life (QoL) and treatment adherence. Among them, the prolonged estrogen suppression associated with the use of adjuvant endocrine therapy in both premenopausal and postmenopausal women can induce life-altering menopausal symptoms, including sexual dysfunction. Moreover, a decrease in bone mineral density and an increased risk of fractures should be carefully considered and prevented whenever …