Obstetrics and Gynecology Commons^™

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin …

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Ultrasound Monitoring Of Extant Adnexal Masses In The Era Of Type 1 And Type 2 Ovarian Cancers: Lessons Learned From Ovarian Cancer Screening Trials, Eleanor L. Ormsby, Edward J. Pavlik, John P. Mcgahan

Obstetrics and Gynecology Faculty Publications

Women that are positive for an ovarian abnormality in a clinical setting can have either a malignancy or a benign tumor with probability favoring the benign alternative. Accelerating the abnormality to surgery will result in a high number of unnecessary procedures that will place cost burdens on the individual and the health delivery system. Surveillance using serial ultrasonography is a reasonable alternative that can be used to discover if changes in the ovarian abnormality will occur that favor either a malignant or benign interpretation. Several ovarian cancer screening trials have had extensive experiences with changes in subclinical ovarian abnormalities in …

Ten Important Considerations For Ovarian Cancer Screening, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

The unique intricacies of ovarian cancer screening and perspectives of different screening methods are presented as ten considerations that are examined. Included in these considerations are: (1) Deciding on the number of individuals to be screened; (2) Anticipating screening group reductions due to death; (3) Deciding on the duration and frequency of screening; (4) Deciding on an appropriate follow-up period after screening; (5) Deciding on time to surgery when malignancy is suspected; (6) Deciding on how screen-detected ovarian cancers are treated and by whom; (7) Deciding on how to treat the data of enrolled participants; (8) Deciding on the most …

Ovarian Cancer Incidence Corrected For Oophorectomy, Lauren A. Baldwin, Quan Chen, Thomas C. Tucker, Connie G. White, Robert N. Ore, Bin Huang

Obstetrics and Gynecology Faculty Publications

Current reported incidence rates for ovarian cancer may significantly underestimate the true rate because of the inclusion of women in the calculations who are not at risk for ovarian cancer due to prior benign salpingo-oophorectomy (SO). We have considered prior SO to more realistically estimate risk for ovarian cancer. Kentucky Health Claims Data, International Classification of Disease 9 (ICD-9) codes, Current Procedure Terminology (CPT) codes, and Kentucky Behavioral Risk Factor Surveillance System (BRFSS) Data were used to identify women who have undergone SO in Kentucky, and these women were removed from the at-risk pool in order to re-assess incidence rates …

Symptoms Relevant To Surveillance For Ovarian Cancer, Robert M. Ore, Lauren Baldwin, Dylan Woolum, Erika Elliott, Christiaan Wijers, Chieh-Yu Chen, Rachel W. Miller, Christopher P. Desimone, Frederick R. Ueland, Richard J. Kryscio, John R. Van Nagell, Edward J. Pavlik

Obstetrics and Gynecology Faculty Publications

To examine how frequently and confidently healthy women report symptoms during surveillance for ovarian cancer. A symptoms questionnaire was administered to 24,526 women over multiple visits accounting for 70,734 reports. A query of reported confidence was included as a confidence score (CS). Chi square, McNemars test, ANOVA and multivariate analyses were performed. 17,623 women completed the symptoms questionnaire more than one time and > 9500 women completed it more than one four times for > 43,000 serially completed questionnaires. Reporting ovarian cancer symptoms was ~245 higher than ovarian cancer incidence. The positive predictive value (0.073%) for identifying ovarian cancer based on symptoms …

Complications From Surgeries Related To Ovarian Cancer Screening, Lauren A. Baldwin, Edward J. Pavlik, Emma Ueland, Hannah E. Brown, Kelsey M. Ladd, Bin Huang, Christopher P. Desimone, John R. Van Nagell, Frederick R. Ueland, Rachel W. Miller

Obstetrics and Gynecology Faculty Publications

The aim of this study was to evaluate complications of surgical intervention for participants in the Kentucky Ovarian Cancer Screening Program and compare results to those of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial. A retrospective database review included 657 patients who underwent surgery for a positive screen in the Kentucky Ovarian Cancer Screening Program from 1988–2014. Data were abstracted from operative reports, discharge summaries, and office notes for 406 patients. Another 142 patients with incomplete records were interviewed by phone. Complete information was available for 548 patients. Complications were graded using the Clavien–Dindo (C–D) Classification of Surgical …

Non-Invasive Placental Perfusion Imaging In Pregnancies Complicated By Fetal Heart Disease Using Velocity-Selective Arterial Spin Labeled Mri, Zungho Zun, Greg Zaharchuk, Nickie Niforatos Andescavage, Mary T. Donofrio, Catherine Limperopoulos

Pediatrics Faculty Publications

The placenta is a vital organ for fetal growth and development during pregnancy. Congenital heart disease (CHD) is a leading cause of morbidity and mortality in newborns. Despite the parallel development of the placenta and fetal heart early in pregnancy, very few studies suggested an association between placental dysfunction and fetal CHD. In this study, we report placental perfusion of healthy pregnancies and pregnancies complicated by fetal CHD measured using advanced fetal MRI techniques. We studied forty-eight pregnant women (31 healthy volunteers and 17 with fetal CHD) that underwent fetal MRI during their second or third trimester of pregnancy. Placental …

Urethral Solitary Fibrous Tumor: A Rare Pathologic Diagnosis Of A Periurethral Mass, Gaby N. Moawad, Elias Abi Khalil, Cheryl Silverbrook, Stephanie Barak, Alice Semerjian, Michael Phillips

Obstetrics and Gynecology Faculty Publications

Solitary fibrous tumors (SFTs) may occur at any site in the body. SFTs can only be conclusively diagnosed based on histopathologic and immunohistochemical characteristics of the tumor. The presence of SFTs in the abdomen and pelvis is extremely rare. To our knowledge no cases of urethral solitary fibrous tumor in the literature have been reported so far. We present a case of a solitary fibrous tumor arising from the urethra in a twenty-three-year-old female presenting with vaginal mass.

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. …

Abnormal Uterine Bleeding Guidelines And Clinical Practice Are Based On Poor Quality Evidence, Mirek Mychajlowycz

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Munro MG, Mainor N, Basu R, Brisinger M, Barreda L. Oral medroxyprogesterone acetate and combination oral contraceptives for acute uterine bleeding: A randomized controlled trial. Obstet Gynecol. 2006 Oct;108(4):924-929. doi:10.1097/01.AOG.0000238343.62063.22

The Kras/Mapk Pathway And Ligand Independent Activation Of Erα: Implications For The Treatment Of Endometrial Cancer, Kari Ring

Dissertations and Theses (Open Access)

Hormonal therapy remains a first line option for the treatment of recurrent endometrial cancer (EC), however, many tumors demonstrate de novo or acquired resistance. Member kinases of the PI3K/AKT and Ras/MAPK pathways activate estrogen receptor α (ERα) independent of estrogen, however, few studies have evaluated the role of the Ras/MAPK pathway in predicting response to hormonal therapy in EC. The aims of this project were to evaluate the role of ligand independent activation of ERα in EC and to explore therapeutic implications for the treatment of recurrent EC.

A xenograft model for recurrent EC was used to evaluate the effect …

Preterm Birth And The Controversy Over Universal Cervical Length Screenings, Elizabeth Mearns, Laura Pizzi Pharmd, Mph, Jason K. Baxter Md, Mscp, Vincenzo Berghella Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Soluble Human Epidermal Growth Factor Receptor 2 (Sher2) As A Potential Risk Assessment, Screening, And Diagnostic Biomarker Of Lung Adenocarcinoma, Abby L. Cosentino-Boehm, Jacqueline M. Lafky, Tammy M. Greenwood, Kimberly D. Kimbler, Marites C. Buenafe, Yuxia Wang, Adam J. Branscum, Ping Yang, Nita J. Maihle, Andre T. Baron

Obstetrics and Gynecology Faculty Publications

Lung cancer is the leading cause of cancer-related death in the United States. Here, we evaluated the potential clinical utility of soluble human epidermal growth factor receptor 2 (sHER2) for the risk assessment, screening, and diagnosis of non-small cell lung cancer (NSCLC) using an unmatched case-control study design. Serum sHER2 concentrations were measured by immunoassay in 244 primary NSCLC cases and 218 healthy controls. Wilcoxon rank-sum tests, logistic regression models, and receiver operating characteristic plots were used to assess whether sHER2 is associated with lung cancer. Median serum sHER2 concentrations are higher in patients with adenocarcinoma than squamous cell carcinoma …

The Pregnancy Project: Impact Of Ultrasound Use During Pregnancy Care, Paige Ricci

Annual Undergraduate Conference on Health and Society

Use of ultrasounds during pregnancy continues to increase and there is much debate as to what the best practice is regarding their use, for what types of patients, at what volume level. Current evidence suggests, the extended routine use of ultrasound technology should be for all women that present complications to screen for structural anomalies during pregnancy. However, others have suggested that excessive ultrasound use may be both unnecessary, costly and potentially harmful. Evidence further suggests that mothers find the use of technology to be security enhancing during pregnancy and through the process of care, and that ultrasound use is …

Is There A Benefit To Suturing Vs. Stapling In Cesarean Section Closure When Comparing Postoperative Pain And Patient Satisfaction?, Jennifer Pilchman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE:The objective of this selective EBM review is to determine whether or not there is a benefit to suturing vs stapling in cesarean section closure when comparing postoperative pain and patient satisfaction.

STUDY DESIGN: Review of three English language primary studies published in 2009 and 2010.

DATA SOURCES: Three randomized control trials (RCTs) comparing the surgical closures for cesarean section delivery. All RCTs were found by the author using MEDLINE, PUBMED, and COCHRANE databases. They are all published articles written in English.

OUTCOME MEASURED: Outcomes were measured by assessing patient satisfaction, postoperative pain, cosmetic appearance and wound complications. Rousseau …

Development Of Fetal Movement Between 26 And 36 Weeks’ Gestation In Response To Vibroacoustic Stimulation, Marybeth Grant-Beuttler, Laura M. Glynn, Amy L. Salisbury, Elyssia Poggi Davis, Carol Holliday, Curt A. Sandman

Psychology Faculty Articles and Research

BACKGROUND: Ultrasound observation of fetal movement has documented general trends in motor development and fetal age when motor response to stimulation is observed. Evaluation of fetal movement quality, in addition to specific motor activity, may improve documentation of motor development and highlight specific motor responses to stimulation.

AIM: The aim of this investigation was to assess fetal movement at 26 and 36-weeks gestation during three conditions (baseline, immediate response to vibro-acoustic stimulation (VAS), and post-response).

DESIGN: A prospective, longitudinal design was utilized.

SUBJECTS: Twelve normally developing fetuses, eight females and four males, were examined with continuous ultrasound imaging.

OUTCOME MEASURES: …

Does Intra-Amniotic Inflammation Influence Pregnancy Outcome After Cerclage Orprogesterone (17ohp-C) Therapy For Midtrimester Short Cervix?, Orion Rust Md, Daniel Kiefer Md, Sean M. Keeler Md, Morgan R. Peltier Phd, Jolene C. Muscat Md, Nazeeh Hanna Md, Anthony M. Vintzileos Md, Cande V. Ananth Phd, Mph

Department of Obstetrics & Gynecology

No abstract provided.

Recognition Of Left Atrial Aneurysm By Fetal Echocardiography., R R. Fountain-Dommer, H B. Wiles, C O. Shuler, S M. Bradley, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

School of Public Health Faculty Research

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

Ai : Artificial Insemination Of Sheep, David Windsor

Journal of the Department of Agriculture, Western Australia, Series 4

Artificial insemination (Al) is used widely in the dairy and beef industries and often performed by farmers themselves. By contrast, sheep breeders generally require assistance from vets when frozen semen is to be used. However, recent experiments with frozen semen are indicating that do-it-yourself Al may soon become a reality.

Complexity Of Fetal Movement Detection Using A Single Doppler Ultrasound Transducer, William A. Russell Jr., Curtis L. Lowery, Patrick J. Baggot, James D. Wilson, Robert Walls, Roger M. Hawk, Pam Murphy

Journal of the Arkansas Academy of Science

The objective of this paper is to discuss the complexity of fetal movement detection encountered during development and implementation of an automated single Doppler ultrasonic transducer based instrument. The single transducer instrument was intended to better quantify the duration, velocity, and magnitude of fetal movements. A Corometrics Model 116 fetal heart rate monitor was modified, and a fetal movement detection algorithm (Russell Algorithm) was developed to detect fetal movements on one and two (data fusion) transducers. A Hewlett-Packard (HP) M-1350-A fetal monitor and the Russell Algorithm were used to detect and record fetal movements concurrently on sixty patients between the …

Factors That Influence Prepared Childbirth Couples' Use Of Epidural Anesthesia For Labor And Delivery, Terri S. Chambers

Community & Environmental Health Theses & Dissertations

The purpose of this study was to identify factors that influence a Prepared Childbirth couple's decision to utilize epidural anesthesia for labor and delivery. Review of the literature indicated a high correlation between epidural use for uncomplicated labors and deliveries and a high incidence of maternal complications and low neonatal neurological and behavioral scores.

A sample of twenty-nine couples was used in this prospective, non-experimental field study for the research. Data were collected utilizing two developed demographic and factual event tools, Rotter's Internal-External Locus of Control Tool and Spanier's Dyadic Marital Adjustment Tool.

Three hypotheses were developed and data were …