Obstetrics and Gynecology Commons^™

Project Prevent: A Randomized Controlled Trial Of Preoperative Vaginal Metronidazole To Decrease Patient Issues And Infections After Hysterectomy, Tana Pradhan, Helen Zhang, Amanda Kadesh, Ama Buskwofie, Sonali Patankar, Sharifa Menon, Timothy Ryntz, Cara Grimes

Abington Jefferson Health Papers

OBJECTIVES: To evaluate if vaginal metronidazole for 5 days before hysterectomy decreases postoperative infections and patient issues.

DESIGN: This randomized trial compared vaginal metronidazole for 5 days before a scheduled hysterectomy to no intervention. Sample size calculation was based on a 20% difference in issues and infection (30% incidence and 10% in the intervention arm) with 80% power and an alpha error of 0.05 and indicated 62 subjects needed in each arm.

SETTING: Outpatient gynecology clinics at a single academic institution.

PARTICIPANTS: 154 subjects were screened for eligibility between July 2020 and September 2022. 133 underwent hysterectomy including 68 subjects …

Targeting Branched N-Glycans And Fucosylation Sensitizes Ovarian Tumors To Immune Checkpoint Blockade, Hao Nie, Pratima Saini, Taito Miyamoto, Liping Liao, Rafal J Zielinski, Heng Liu, Wei Zhou, Chen Wang, Brennah Murphy, Martina Towers, Tyler Yang, Yuan Qi, Toshitha Kannan, Andrew Kossenkov, Hiroaki Tateno, Daniel T Claiborne, Nan Zhang, Mohamed Abdel-Mohsen, Rugang Zhang

Faculty, Staff and Student Publications

Aberrant glycosylation is a crucial strategy employed by cancer cells to evade cellular immunity. However, it's unclear whether homologous recombination (HR) status-dependent glycosylation can be therapeutically explored. Here, we show that the inhibition of branched N-glycans sensitizes HR-proficient, but not HR-deficient, epithelial ovarian cancers (EOCs) to immune checkpoint blockade (ICB). In contrast to fucosylation whose inhibition sensitizes EOCs to anti-PD-L1 immunotherapy regardless of HR-status, we observe an enrichment of branched N-glycans on HR-proficient compared to HR-deficient EOCs. Mechanistically, BRCA1/2 transcriptionally promotes the expression of MGAT5, the enzyme responsible for catalyzing branched N-glycans. The branched N-glycans on HR-proficient tumors augment their …

Neutrophil Elastase Remodels Mammary Tumors To Facilitate Lung Metastasis, Amriti R Lulla, Said Akli, Cansu Karakas, Joseph A Caruso, Lucas D Warma, Natalie W Fowlkes, Xiayu Rao, Jing Wang, Kelly K Hunt, Stephanie S Watowich, Khandan Keyomarsi

Faculty, Staff and Student Publications

Metastatic disease remains the leading cause of death due to cancer, yet the mechanism(s) of metastasis and its timely detection remain to be elucidated. Neutrophil elastase (NE), a serine protease secreted by neutrophils, is a crucial mediator of chronic inflammation and tumor progression. In this study, we used the PyMT model (NE+/+ and NE-/-) of breast cancer to interrogate the tumor-intrinsic and -extrinsic mechanisms by which NE can promote metastasis. Our results showed that genetic ablation of NE significantly reduced lung metastasis and improved metastasis-free survival. RNA-sequencing analysis of primary tumors indicated differential regulation of tumor-intrinsic actin cytoskeleton signaling pathways …

Objective Assessment Of Rupture Parameters In Intact And Acute Post-Cystorrhaphy Cadaveric Bladders, Geoffrey D. Towers, Dani G. Zoorob, Rose A. Maxwell, Ashley N. Reid, Jerome L. Yaklic, Jason C. Massengill

Obstetrics and Gynecology Faculty Publications

Background: Certain procedures, particularly those used to treat symptoms of bladder pain syndrome/interstitial cystitis (BPS/IC), involve filling the bladder to or over its capacity for visualization and/or relief of symptoms. Rarely, if excessive pressure or volume is used, bladders may rupture causing significant harm to the patient. The purpose of this study was to identify baseline data for pressure and volume when hydrodistention is attempted in explanted cadaveric bladders, as well as determine bladder rupture pressure changes in the acute post-cystorrhaphy state. Methods: Eight explanted cadaveric bladders were filled using a systematic digital pump system. Intravesical pressure and volume were …

El Derecho A La Interrupción Voluntaria Del Embarazo A Inicios Del Gobierno De Javier Milei (Argentina, 2024) / The Right To The Voluntary Interruption Of Pregnancy At The Beginning Of The Government Of Javier Milei (Argentina, 2024), Willa Rudel

Independent Study Project (ISP) Collection

El objetivo de esta investigación fue entender las realidades del activismo en relación con el derecho al aborto en Argentina en el período después de la aprobación de la ley 27.610 del derecho a la interrupción voluntaria del embarazo, particularmente en 2020 y durante el gobierno actual de Javier Milei. Para responder la pregunta que articula la presente investigación, realicé seis entrevistas con activistas procedentes de una variedad de formaciones y con distintos tipos de participación en el movimiento. Primero describo la historia del activismo a favor del aborto en Argentina hasta la aprobación de la ley y el estado …

Exploring The Medicalization Of Menstruation: Analyzing Menstrual Hygiene Initiatives By Igos, Non-Profits And National Government In Switzerland, Victoria Wright

Independent Study Project (ISP) Collection

Menstrual health serves as a critical indicator of reproductive health. It is pivotal in achieving various Sustainable Development Goals (SDGs) related to women's and girls' comfort, agency, participation, safety, well-being, and dignity (Loughnan et al., 2020). This research investigates the medicalization of menstruation in Switzerland through a mixed-methods approach examining the strategies and roles of key stakeholders such as the WHO, local government initiatives, and NGOs in shaping the landscape of menstrual medicalization.

The findings reveal that while medicalization has brought about progressive changes, including the introduction of menstrual leave policies, it has resulted in a complex regulatory landscape, increased …

Conceptualizando La Movilidad Y Movimiento De Mujeres Indígenas Embarazadas En Búsqueda De Servicios Médicos Bajo Una Perspectiva Migratoria, Nazareth Castro

Independent Study Project (ISP) Collection

El traslado de mujeres indígenas embarazadas en Oaxaca hacia la ciudad de Oaxaca de Juárez debido a la falta de centros de salud en sus localidades se ha convertido en una realidad arraigada, impulsada en gran medida por el impacto del flujo migratorio por razones económicas durante finales del siglo XX. Sin embargo, este proceso de migración plantea una serie de complejidades para las mujeres, quienes enfrentan experiencias negativas debido a sus múltiples identidades que resultan en una exclusión social tanto dentro como fuera de sus comunidades de origen. Esta dinámica puede entenderse desde una perspectiva feminista multicéntrado, que las …

Learning To Lead: The Evolution Of A Pilot Leadership Curriculum For Gynecologic Oncology Fellows At The Ohio State University., Monica D Levine, Vincent M Wagner, Courtney J Riedinger, Wafa Khadraoui, Paulina J Haight, Molly Morton, David A Barrington, Corinne A Calo, Antonio V Castaneda, Michelle Lightfoot, Julia Chalif, Anna Gonzalez, David E Cohn

Medical Education Articles

•Leadership training is under-emphasized in traditional medical education.•An effective leadership curriculum must be dynamic and requires genuine investment from participants.•Through didactic education, self-reflection, and real-world perspective we can actively mold future leaders in gynecologic oncology.

Learning Circles: Promoting Inclusive Care Starting In The Classroom, April Graham, Kindsey Gattman, Tobias Johnson

Articles, Abstracts, and Reports

No abstract provided.

Efficacy Of Behavioral Economic Nudges To Assist Teen Mothers: The Healthy Adolescent Transitions Randomized Controlled Trial., Jack Stevens, Joseph Rausch, Robyn Lutz, Ngozi Osuagwu

Women’s Health Articles

Communities may often lack the resources to deliver intensive programs to assist teen mothers, and many eligible adolescents may decline participation in lengthy interventions. Therefore, alternative approaches involving less resource and time may be needed. Behavioral economics (BE) can inform the development of such novel interventions. BE often feature low-intensity approaches designed to "nudge" people to help them reach their long-term goals. Nudges can include giving reminders, making the desired behavior more convenient, and optimizing the verbal presentation of recommended options. Three hundred thirty-one American adolescents (ages 14 to 19) who were 22 to 35 weeks pregnant were enrolled in …

Digital Health Technologies For High-Risk Pregnancy Management: Three Case Studies Using Digilego Framework, Sahiti Myneni, Alexandra Zingg, Tavleen Singh, Angela Ross, Amy Franklin, Deevakar Rogith, Jerrie Refuerzo

Faculty, Staff and Student Publications

OBJECTIVE: High-risk pregnancy (HRP) conditions such as gestational diabetes mellitus (GDM), hypertension (HTN), and peripartum depression (PPD) affect maternal and neonatal health. Patient engagement is critical for effective HRP management (HRPM). While digital technologies and analytics hold promise, emerging research indicates limited and suboptimal support offered by the highly prevalent pregnancy digital solutions within the commercial marketplace. In this article, we describe our efforts to develop a portfolio of digital products leveraging advances in social computing, data science, and digital health.

METHODS: We describe three studies that leverage core methods from

RESULTS: Scalable social computing models using deep learning classifiers …

Machine Learning-Enabled Maternal Risk Assessment For Women With Pre-Eclampsia (The Piers-Ml Model): A Modelling Study, Tünde Montgomery-Csobán, Kimberley Kavanagh, Paul Murray, Chris Robertson, Sarah J E Barry, U Vivian Ukah, Beth A Payne, Kypros H Nicolaides, Argyro Syngelaki, Olivia Ionescu, Ranjit Akolekar, Jennifer A Hutcheon, Laura A Magee, Peter Von Dadelszen, Piers Consortium

Faculty, Staff and Student Publications

BACKGROUND: Affecting 2-4% of pregnancies, pre-eclampsia is a leading cause of maternal death and morbidity worldwide. Using routinely available data, we aimed to develop and validate a novel machine learning-based and clinical setting-responsive time-of-disease model to rule out and rule in adverse maternal outcomes in women presenting with pre-eclampsia.

METHODS: We used health system, demographic, and clinical data from the day of first assessment with pre-eclampsia to predict a Delphi-derived composite outcome of maternal mortality or severe morbidity within 2 days. Machine learning methods, multiple imputation, and ten-fold cross-validation were used to fit models on a development dataset (75% of …

Clinical Epidemiological Characteristics And Risk Factors For Severity Of Sars-Cov-2 Pneumonia In Pediatric Patients: A Hospital-Based Study In Vietnam, Sang N Nguyen, Lam T Vu, Ha T Nguyen, Giang H Dao, Anh Ngoc T Nguyen

Faculty, Staff and Student Publications

Introduction Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2, which can cause organ failure in several organs, cardiac problems, or acute respiratory distress syndrome (ARDS). Identifying clinical epidemiological characteristics and risk factors for complications of COVID-19 allows clinicians to diagnose and treat promptly. Objectives This study aims to describe the clinical epidemiological characteristics of COVID-19 and assess risk factors for the severity of SARS-CoV-2 pneumonia in children treated at Haiphong Children's Hospital. Methods A descriptive cross-sectional study was conducted in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from January 1, 2022, to December 31, 2022. Results In …

Long-Term Outcomes Of Vulvar Or Vaginal Cancer Patients Undergoing Laparoendoscopic Single-Site Inguinal Lymphadenectomy, Jing-Yun Xu, Tian-Xiang Yu, Xiao-Ming Guan, Bo Ding, Mu-Lan Ren, Yang Shen

Faculty, Staff and Students Publications

INTRODUCTION: Laparoendoscopic single-site inguinal lymphadenectomy (LESS-IL), a minimally invasive technique, has been reported in patients with vulvar or vaginal cancer regarding its safety and feasibility. However, the long-term outcomes, especially oncologic outcomes, are still lacking. We aimed to evaluate the long-term outcomes of LESS-IL to confirm its safety further.

PATIENTS AND METHODS: Data were prospectively collected from patients with vulvar or vaginal cancer who underwent LESS-IL at our institution between July 2018 and June 2021. The patients were followed up for at least 12 months. All procedures were performed according to treatment standards. Short- and long-term complications and oncologic outcomes …

Normal Risk Ovarian Screening Study: 21-Year Update, Chae Young Han, Karen H Lu, Gwen Corrigan, Alexandra Perez, Sharlene D Kohring, Joseph Celestino, Deepak Bedi, Enrique Bedia, Therese Bevers, David Boruta, Matthew Carlson, Laura Holman, Leroy Leeds, Cara Mathews, Georgia Mccann, Richard G Moore, Matthew Schlumbrecht, Brian Slomovitz, Dan Tobias, Yvette Williams-Brown, Michael W Bevers, Jinsong Liu, Terrie G Gornet, Beverly C Handy, Zhen Lu, Jacob S Bedia, Steven J Skates, Robert C Bast

Faculty, Staff and Student Publications

Purpose: The Normal Risk Ovarian Screening Study (NROSS) tested a two-stage screening strategy in postmenopausal women at conventional hereditary risk where significantly rising cancer antigen (CA)-125 prompted transvaginal sonography (TVS) and abnormal TVS prompted surgery to detect ovarian cancer.

Methods: A total of 7,856 healthy postmenopausal women were screened annually for a total of 50,596 woman-years in a single-arm study (ClinicalTrials.gov identifier: NCT00539162). Serum CA125 was analyzed with the Risk of Ovarian Cancer Algorithm (ROCA) each year. If risk was unchanged and < 1:2,000, women returned in a year. If risk increased above 1:500, TVS was undertaken immediately, and if risk was intermediate, CA125 was repeated in 3 months with a further increase in risk above 1:500 prompting referral for TVS. An average of 2% of participants were referred to TVS annually.

Results: Thirty-four patients were referred for operations detecting 15 ovarian cancers and two borderline tumors with 12 …

Correlation Of Sonographic With Intraoperative Findings In Laparoscopic Managed Ectopic Pregnancies, A 10-Year Synopsis: A Retrospective Observational Study, Steve Mutiso

Obstetrics and Gynaecology, East Africa

Background: Ectopic pregnancies (EP) are a common pregnancy complication that's associated with significant morbidity and rarely mortality if not managed properly. Ultrasound examination forms the cornerstone of diagnosis of EP with some sonographic features occasionally not correlating with intraoperative findings. We set out to conduct an audit of EP managed surgically at our hospital for a 10-year period and discern the correlation and prediction of sonographic findings to intraoperative findings.

Methods: This study was designed as a Retrospective Observational Study based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of …

Long-Term Health Related Quality Of Life Following Uterine Fibroid Embolization In A Predominantly Black African Population: A Retrospective Cohort Study, Michael Kioko, Marleen Temmerman, Timona Obura, Adelaide Lusambili

Obstetrics and Gynaecology, East Africa

Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. The study assessed long-term quality of life post-uterine fibroid embolization in a mostly black population, noting scanty local or African research on this topic despite evidence suggesting a higher fibroid burden among black women. This retrospective study examined patients who underwent UFE from 2009 to 2014. Participants completed online demographic and UFS-QOL surveys. Statistical tests included Wilcoxon signed rank tests for HRQOL score differences and Pearson correlation for associations between independent …

Incidental Actinomycosis In A 44-Year-Old Female During Total Abdominal Hysterectomy For Abnormal Uterine Bleeding: A Case Report, Willbroad Kyejo, Ally Zain Ismail, Abduel Kitua, Gregory Ntiyakunze, Munawar Kaguta, Ally Mwawnga

Family Medicine, East Africa

Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report presents a case of peritoneal actinomycosis incidentally discovered during a total abdominal hysterectomy in a 44-year-old female with refractory abnormal uterine bleeding and a history of long-term intrauterine contraceptive device use. The patient presented with persistent abnormal uterine bleeding despite conservative management. Intraoperative findings during total abdominal hysterectomy revealed peritoneal involvement, prompting histopathological evaluation confirming actinomycosis. This case highlights diagnostic complexities associated with actinomycosis, emphasizing the significance of histopathological confirmation. Postoperative management with antibiotics demonstrated favorable outcomes, supporting their efficacy …

The Effect Of Cervical Pessary On Increasing Gestational Age At Delivery In Twin Pregnancies With Asymptomatic Short Cervix: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Amir Hossein Norooznezhad, Nikan Zargarzadeh, Ali Javinani, Seyedeh Maedeh Nabavian, Shohra Qaderi, Shayan Mostafaei, Vincenzo Berghella, Yinka Oyelese, Alireza A. Shamshirsaz

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The incidence of preterm delivery is much higher in twin pregnancies than in singletons and even higher if a short cervical length is detected in the second trimester. Studies are contradictory regarding the efficacy of a cervical pessary to decrease preterm birth in twin pregnancies and short cervical length. To conduct a systematic review and meta-analysis investigating the efficacy of cervical pessary in prolonging gestation, preventing preterm birth, and reducing adverse neonatal outcomes in twin pregnancies with an asymptomatic short cervix.

DATA SOURCES: PubMed, Scopus, Web of Science, and ClinicalTrials.org were searched for randomized controlled trials from inception to …

Ndrgs In Breast Cancer: A Review And In Silico Analysis, Emilly S Villodre, Anh P N Nguyen, Bisrat G Debeb

Faculty, Staff and Student Publications

Simple Summary

Breast cancer is the most common cancer in women and one of the deadliest. While survival rates for patients with breast cancer have seen notable improvements in recent decades, current treatment strategies still face significant limitations, especially for patients with aggressive, therapy-resistant, and metastatic breast cancers. For this reason, it is important to identify new targets in order to develop more effective therapeutic strategies. The N-myc downstream regulated gene family (NDRGs), comprising NDRG1, NDRG2, NDRG3, and NDRG4, has been previously described as tumor suppressors. However, recent findings challenge this perception, particularly for NDRG1, …

Affinity-Tagged Smad1 And Smad5 Mouse Lines Reveal Transcriptional Reprogramming Mechanisms During Early Pregnancy, Zian Liao, Suni Tang, Kaori Nozawa, Keisuke Shimada, Masahito Ikawa, Diana Monsivais, Martin Matzuk

Faculty, Staff and Students Publications

Endometrial decidualization, a prerequisite for successful pregnancies, relies on transcriptional reprogramming driven by progesterone receptor (PR) and bone morphogenetic protein (BMP)-SMAD1/SMAD5 signaling pathways. Despite their critical roles in early pregnancy, how these pathways intersect in reprogramming the endometrium into a receptive state remains unclear. To define how SMAD1 and/or SMAD5 integrate BMP signaling in the uterus during early pregnancy, we generated two novel transgenic mouse lines with affinity tags inserted into the endogenous SMAD1 and SMAD5 loci (Smad1^HA/HA and Smad5^PA/PA). By profiling the genome-wide distribution of SMAD1, SMAD5, and PR in the mouse uterus, we demonstrated …

The Ethics And Practice Of Periviability Care, Alex C Vidaeff, Joseph W Kaempf

Faculty, Staff and Students Publications

Since the 1960s, the gestational age at which premature infants typically survive has decreased by approximately one week per decade [1]. Survival is now reported at remarkably early gestational ages. In 2022, the Vermont Oxford Network reported neonatal intensive care unit (NICU) survival rates of 21%, 46%, and 63% at 22, 23, and 24 weeks’ gestation [2]. Presently, in industrialized nations, the so-called periviability interval refers to the gestational age period of possible survival that extends from approximately 22 to 25 weeks’ gestation. Newborns born within this period are distinguished by their need for extraordinarily complex …

Zika Virus Prevention Behaviors And Knowledge Among Male Partners Of Pregnant People And Lack Of Condom Use As A Prevention Behavior From The Zika En Embarazadas Y Niños (Zen) Prospective Cohort Study, Colombia, Christina L Sancken, Ayzsa Tannis, Sandra A Amouzou, Veronica Burkel, Jeffrey M Carlson, Suzanne Newton, Suzanne M Gilboa, Maritza Gonzalez, Diana Valencia, Van T Tong, Martha Ospina

Faculty, Staff and Student Publications

Objective: Zika virus (ZIKV) infection in pregnancy can cause brain and eye abnormalities and neurodevelopmental sequelae. In the absence of medical countermeasures, behavioral interventions were recommended to prevent mosquito bites and sexual transmission of ZIKV. This report uses data from the Zika en Embarazadas y Niños (ZEN) prospective cohort study in Colombia to describe the knowledge, attitudes, and behaviors (KAB) related to ZIKV prevention in male partners compared to those of their pregnant partners at study enrollment during February 2017-2018.

Results: Most male partners reported wearing protective clothing such as long pants (97.6%) and long sleeves (72.8%), as well as …

Effects Of Maternal-Infant Golden Hour On Breastfeeding, Julina A. Wall-Penner, Katilyn Rasmussen, Madeline Suderman

SACAD: Scholarly Activities

Abstract

This study examines the effects of immediate maternal-infant skin-to-skin contact, and how those effects compare to mothers and babies who have delayed or skin-to-skin. Skin-to-skin contact, also known as “the golden hour”, is a remarkable practice that occurs immediately after birth. During this intimate bonding experience, the newborn is placed directly on the mother's chest, their tiny body nestled against her warm skin. Studies have shown numerous benefits from this practice. Breastfeeding success through early initiation is one the benefits this study focuses on. This cohort observational study is recommended to take place at Hays Medical Center with mothers …

Establishment Of Murine Pregnancy Requires The Promyelocytic Leukemia Zinc Finger Transcription Factor, Lan Hai, Vineet K Maurya, Francesco J Demayo, John P Lydon

Faculty, Staff and Students Publications

Using an established human primary cell culture model, we previously demonstrated that the promyelocytic leukemia zinc finger (PLZF) transcription factor is a direct target of the progesterone receptor (PGR) and is essential for progestin-dependent decidualization of human endometrial stromal cells (HESCs). These in vitro findings were supported by immunohistochemical analysis of human endometrial tissue biopsies, which showed that the strongest immunoreactivity for endometrial PLZF is detected during the progesterone (P4)-dominant secretory phase of the menstrual cycle. While these human studies provided critical clinical support for the important role of PLZF in P4-dependent HESC decidualization, functional validation in vivo was not …

What Do Cervical Cancer Patients Know, How Do They Learn, And Who Do They Tell? A Pilot Study, Sharon Larson, Brian Mcanany, Ilene Ladd, Radhika Gogoi

College of Population Health Faculty Papers

BACKGROUND: This study explored what patients identified with cervical cancer know about the link between human papillomavirus (HPV) and cervical cancer and where they learned this information. Patients share a great deal of information with family, friends and colleagues and we were interested in the accuracy and sources of information they are sharing.

METHODS: Patients identified through the EHR of a health system who had a history of cervical cancer were invited to participate in a brief survey of their experience. The sample represents an opportunity sample of patients who responded.

RESULTS: Generally, these patients, drawn from the Geisinger Health …

Apparent Diffusion Coefficient Values Predict Response To Brachytherapy In Bulky Cervical Cancer, Elizabeth E Dong, Junqian Xu, Joo-Won Kim, Jason Bryan, Jewel Appleton, Daniel A Hamstra, Michelle S Ludwig, Alexander N Hanania

Faculty, Staff and Students Publications

BACKGROUND: Diffusion-weighted magnetic resonance imaging (DWI) provides a measurement of tumor cellularity. We evaluated the potential of apparent diffusion coefficient (ADC) values obtained from post-external beam radiation therapy (EBRT) DWI and prior to brachytherapy (BT) to predict for complete metabolic response (CMR) in bulky cervical cancer.

METHODS: Clinical and DWI (b value = 500 s/mm2) data were obtained from patients undergoing interstitial BT with high-risk clinical target volumes (HR-CTVs) > 30 cc. Volumes were contoured on co-registered T2 weighted images and 90th percentile ADC values were calculated. Patients were stratified by CMR (defined by PET-CT at three months post-BT). Relation of …

Immuno-Molecular Targeted Therapy Use And Survival Benefit In Patients With Stage Ivb Cervical Carcinoma In Commission On Cancer, Collin A Sitler, Chunqiao Tian, Chad A Hamilton, Michael T Richardson, John K Chan, Daniel S Kapp, Charles A Leath, Yovanni Casablanca, Christina Washington, Nicole P Chappell, Ann H Klopp, Craig D Shriver, Christopher M Tarney, Nicholas W Bateman, Thomas P Conrads, George Larry Maxwell, Neil T Phippen, Kathleen M Darcy

Faculty, Staff and Student Publications

PURPOSE: To investigate IMT use and survival in real-world stage IVB cervical cancer patients outside randomized clinical trials.

METHODS: Patients diagnosed with stage IVB cervical cancer during 2013-2019 in the National Cancer Database and treated with chemotherapy (CT) ± external beam radiation (EBRT) ± intracavitary brachytherapy (ICBT) ± IMT were studied. The adjusted hazard ratio (AHR) and 95% confidence interval (CI) for risk of death were estimated in patients treated with vs. without IMT after applying propensity score analysis to balance the clinical covariates.

RESULTS: There were 3164 evaluable patients, including 969 (31%) who were treated with IMT. The use …

Sex Differences In Revascularization, Treatment Goals, And Outcomes Of Patients With Chronic Coronary Disease: Insights From The Ischemia Trial, Harmony R Reynolds, Derek D Cyr, C Noel Bairey Merz, Leslee J Shaw, Bernard R Chaitman, William E Boden, Karen P Alexander, Yves D Rosenberg, Sripal Bangalore, Gregg W Stone, Claes Held, John Spertus, Kaatje Goetschalckx, Olga Bockeria, Jonathan D Newman, Jeffrey S Berger, Ahmed Elghamaz, Renato D Lopes, James K Min, Daniel S Berman, Michael H Picard, Raymond Y Kwong, Robert A Harrington, Boban Thomas, Sean M O'Brien, David J Maron, Judith S Hochman, Ischemia Research Group

Faculty, Staff and Student Publications

BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management.

METHODS AND RESULTS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for …

Hypertension In Pregnancy Among Immigrant And Swedish Women: A Cohort Study Of All Pregnant Women In Sweden, Per Wändell, Casey Crump, Xinjun Li, Nouha Saleh Stattin, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

BACKGROUND: Little is known about risks of hypertensive disorders of pregnancy in both first- and second-generation immigrant women in Europe and other Western countries; such knowledge may help elucidate the influence of genetic versus social factors on such risks. We aimed to study both first- and second-generation immigrant women for the presence of all types of hypertension (preexisting hypertension, gestational hypertension, preeclampsia, and eclampsia) during pregnancy.

METHODS AND RESULTS: A cohort study was conducted using data derived from the Swedish National Birth Register, the National Patient Register, and the total Population Register. We used Cox regression analysis to compute hazard …