Proceedings in Obstetrics and Gynecology
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Impact of an entrustable professional activities-based assessment system
Get PDFBackground: Beginning in 2014, all Accreditation Counsel of Graduate Medical Education (ACGME) accredited residency programs were required to move to a Milestones-based system for biannual resident assessment. The resident assessment system for the Virginia Tech-Carilion Obstetrics and Gynecology (OB/GYN) residency program was re-designed to meet this requirement in July, 2014. The ACGME Milestones based assessment tool was identified on multiple faculty surveys as an area for improvement. To address this issue, an entrustable professional activities (EPA) based assessment system was designed and implemented for assessment of all OB/GYN rotations.Objective: To evaluate the impact of an EPA based resident assessment system on faculty member’s evaluation of resident assessment tools.Methods: In this prospective quality improvement study, a survey was sent to all faculty members prior to the implementation of the EPA-based assessment system. The same survey was performed three months after the implementation of the new system. To facilitate analysis, each level of agreement was assigned a numerical value (1-5). The results were aggregated, and were analyzed using t-tests, assuming unequal variances.Results: Sixty-eight percent of the faculty responded to the first survey, and 67% responded to the follow up survey. Statistically significant (p<.05) improvements were noted in most measures of the EPA based assessment tool including “ease of use” (2.2 vs 4.4, p< 0.001) and “accurate representation of resident performance” (2.5 vs 3.9, p <0.001).Conclusion: An EPA based resident evaluation system significantly improved teaching faculty’s impression of most domains of our OB/GYN resident assessment tools
Multimodal perioperative pain protocol for Gynecologic Oncology laparotomy reduces length of hospital stay
Get PDFOur primary objective was to evaluate the impact of a multimodal perioperative pain regimen on length of hospital stay for patients undergoing laparotomy with a gynecologic oncologist
Effects of biological factors on the expression of arginine vasopressin receptors
Get PDFArginine vasopressin (AVP) is a hormone that functions to regulate blood pressure and bodily fluid homeostasis. Vasopressin has three main receptors AVPR1a, AVPR1b, and AVPR2 which were investigated in this project along with OXTR, LNPEP, and CUL5. AVPR1a functions in the smooth muscle and causes vasoconstriction, AVPR1b functions in the pituitary helping to regulate adrenocorticotropic hormone release, and AVPR2 is expressed highly in the kidneys and works to concentrate urine. This project investigates how these various receptors are expressed with different factors related to pregnancy such as, sex of the baby, chronically hypertensive mothers, and gestational age at deliver
Healthy moms. Healthy babies.
Get PDFHealthy moms. Healthy babies. That's my goal as a board certified OB/GYN.The University of Iowa, most specifically the Women's Health Department, will always remain a special place to me. I will forever be grateful for the knowledge I learned, the support I continue to receive, and for the camaraderie that we have in support of Women's health for all of Iowa
Reflections on the University of Iowa Department of Obstetrics and Gynecology
Get PDFMy association with the University of Iowa Department of Obstetrics and Gynecology began over 30 years ago as a fourth year medical student when I did a rotation on the High Risk Antepartum service. I am fortunate to have been trained by, and my care supported by, the University of Iowa Department of Obstetrics and Gynecology
Relapsed ovarian high-grade serous carcinoma with long-term survival associated with synchronous primary squamous cell carcinoma of the colon
Get PDFHigh-grade serous ovarian cancer (HGSOC) is the most common and also the most aggressive subtype of ovarian cancer while squamous cell carcinoma (SCC) of the colon is an extremely rare histologic subtype of all colonic malignancies with poor prognosis.Here we report a unique case of synchronous primary SCC of the colon and second recurrence of HGSOC in a patient with 15-years survival. Our patient developed two recurrent HGSOCs with disease-free survival time of five and nine years, respectively. The second recurrence of HGSOC was associated with the synchronous primary SCC of the ascending colon and was further complicated with the patient′s development of platinum resistance. Awareness of this unusual occurrence should emphasize the need for adequate sampling of tumor tissue in patients with relapsing ovarian cancer. Reports of more cases of SCC of the colon would possibly help to establish appropriate management modality and strategies for treatment
Combination of myasthenia gravis and HELLP Syndrome in pregnancy: case report and literature review
Get PDFMyasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. Preeclampsia/HELLP Syndrome is a potentially life-threatening pregnancy complication. The combination of HELLP Syndrome and MG is challenging because the preferred treatment regimens for both conditions generally contradict each other. Our aim is to describe the management options when these two diseases occur simultaneously. We present a case in which a woman with an established diagnosis of MG developed HELLP Syndrome at 31 weeks gestation. Magnesium sulfate prophylaxis was not utilized because of the patient’s MG diagnosis. A cesarean delivery was performed. Reported cases with combined diagnoses of MG and preeclampsia/HELLP Syndrome are reviewed and adjustments to treatment plans are discussed. Management of such patients should be done with a multidisciplinary approach in advanced medical centers with careful consideration of the medications used
Good News About Women & HPV by Alexander Mortakis MD, PhD
Get PDFDr. Mortakis is recognized internationally as an expert in HPV infections and lower genital tract diseases. ‘Good News About Women & HPV’ was written to provide an accurate and informational resource for his many patients who are concerned about HPV infections and their health. This book is a practical, hands-on approach for women as well as their partners. In addition to well organized chapters (starting with definitions and an introduction to the HPV virus), he poses and answers over 300 questions. The format is straight forward and presents information using both medical terms and lay definitions to assist the reader in gaining a clear understanding of the information
Higher body weight is associated with lower concentrations of progesterone and estrogen in early pregnancy following in vitro fertilization
Get PDFTo evaluate if body weight impacts progesterone and estradiol concentration levels in early pregnancy in women conceiving following single embryo transfer
Full term delivery of a Harlequin ichthyosis baby: a case report
Get PDFHarlequin ichthyosis (HI) is one of the most severe and rare autosomal recessive congenital ichthyosis (ARCI), characterized by severe hyperkeratosis, extensive fissuring and a variable degree of cutaneous malformations. Here we report a case of 22 years old female patient in her first pregnancy. The baby was born at 39 weeks of gestation from non-consanguineous parents. At birth the baby had thick skin with deep fissures. The baby was admitted to the neonatal intensive care unit and survived for 11 days