Copyright (c) 2010 Thomas Jefferson University All rights reserved. http://jdc.jefferson.edu/obgynfp Recent documents in Department of Obstetrics and Gynecology Faculty Papers en-us Thu, 25 Feb 2010 23:54:49 PST 3600 http://jdc.jefferson.edu/obgynfp/10 http://jdc.jefferson.edu/obgynfp/10 Wed, 24 Feb 2010 08:30:16 PST Objective: To estimate if cervical biopsy at the time of colposcopy changes the management or outcome of abnormal cervical cytology during pregnancy. Conclusion: Biopsy of suspected cervical lesions can be safely deferred until after pregnancy because there were no significant changes between antepartum and postpartum CC and no missed cases of cervical cancer were detected. N. S. Seligman, MD http://jdc.jefferson.edu/obgynfp/9 http://jdc.jefferson.edu/obgynfp/9 Wed, 24 Feb 2010 08:22:55 PST Objective: (1) To estimate the risk of GI and pouch complications during pregnancy; (2) to estimate the effect of pregnancy and mode of delivery on pouch function.Conclusions: Pregnancy after IPAA is overall safe and is associated with limited gastrointestinal complications. Neither pregnancy or mode of delivery appears to have an affect on pouch function. N. S. Seligman, MD http://jdc.jefferson.edu/obgynfp/8 http://jdc.jefferson.edu/obgynfp/8 Wed, 24 Feb 2010 08:16:41 PST Objective: To determine whether 17-alpha-hydroxyprogesterone caproate (17P) reduces the incidence of preterm birth (PTB) in women with a history-indicated cerclage. Conclusions: 17P does not appear to have an effect on preterm birth <35 weeks in women with a history-indicated cerclage. D. MacKeen, MD http://jdc.jefferson.edu/obgynfp/7 http://jdc.jefferson.edu/obgynfp/7 Wed, 24 Feb 2010 08:09:52 PST Objective: To estimate whether the use of 17 alpha-hydroxyprogesterone caproate (17P) in women with an ultrasound-indicated cerclage (UIC) reduces the rate of preterm birth (PTB).Conclusions: Among women with a prior spontaneous PTB and current UIC for CL<25mm, 17P did not reduce the rate of PTB <35 weeks. T. J. Rafael http://jdc.jefferson.edu/obgynfp/6 http://jdc.jefferson.edu/obgynfp/6 Thu, 18 Feb 2010 07:55:01 PST Objective: To determine the appropriate duration of prolonged monitoring following decelerations noted on outpatient non-stress test (NST).Conclusion: Prolonged monitoring beyond 120 min is not associated with increased rate of delivery secondary to NRFS or worse neonatal outcome measured by the 5 minute Apgar score. Monitoring after a deceleration on outpatient NST may be limited to less than 120 minutes. Larger studies are needed to confirm this finding. P. Koduri, MD http://jdc.jefferson.edu/obgynfp/5 http://jdc.jefferson.edu/obgynfp/5 Wed, 27 Jan 2010 10:56:25 PST Proficiency in the clinical skill of effective hand washing is integral to high quality health care. Studies at our hospital revealed that in 2008, of 1215 direct, anonymous, observations of residents and attendings, only 53.3% washed their hands correctly during clinical activities. Medical students in fiscal year 2009 (July 1, 2008-June 30 2009) had a 52% compliance rate from 109 observations. This data prompted our hospital to work with the faculty of the University Clinical Skills and Simulation Center (UCSSC) to develop a module on the indications and technique of effective handwashing. This intervention, using multimedia simulation was introduced to our interns during their orientation program. K. Berg http://jdc.jefferson.edu/obgynfp/4 http://jdc.jefferson.edu/obgynfp/4 Wed, 27 Jan 2010 10:47:43 PST The ACGME requires that all residents are competent in performing basic invasive clinical procedures. Although simulation models have been used in other programs to teach these skills to interns with the intent to provide training and skills attainment before learning and performing on real patients, a large scale, mandatory simulation training, in which every incoming intern must satisfactorily complete training in a simulation center, prior to starting their intern year, has yet to be described. We describe such a curricular intervention produced in our Simulation Center. C. Sultana http://jdc.jefferson.edu/obgynfp/3 http://jdc.jefferson.edu/obgynfp/3 Thu, 24 May 2007 06:32:57 PDT Basic science research into the mechanism of the development of endometriosis, its persistence and resulting pain has begun to improve our understanding of how various therapeutic options work. While none of the available treatments resolves the underlying disease process, there are a growing number of alternatives. One of the more recent classes of medical options includes the GnRH agonist and antagonists. While at present this class of medical options is the most expensive and involved in implementation, they prove invaluable in terms of offering an aggressive, successful alternative for many patients. Furthermore, they may act directly on endometrial lesions in a therapeutic manner. This discussion will be oriented toward endometriosis pain management, but many of the medical manipulations may be therapeutic for infertility treatment as well if only by preventing the need for aggressive or emergency surgical management of endometriosis, especially in young women. Frances R. Batzer http://jdc.jefferson.edu/obgynfp/2 http://jdc.jefferson.edu/obgynfp/2 Thu, 17 Aug 2006 12:48:52 PDT Objective The purpose of this study was to review the American College of Obstetricians and Gynecologists practices bulletins to quantify the type of recommendations and references and determining whether there are any differences between obstetric and gynecologic bulletins.Study design All practice bulletins published from June 1998 to December 2004 were reviewed. Odds ratios and 95% confidence intervals were calculated.Results The 55 practice bulletins contained 438 recommendations of which 29% are level A, 33% level B, and 38% level C. The 55 bulletins cite 3953 references of which 17% are level I, 46% level II, 34% level III, and 3% others. Level A recommendations were significantly more likely among the 23 gynecologic than 32 obstetric bulletins (37% versus 23%, odds ratios 1.95, 95% confidence intervals 1.28, 2.96). The study types referenced in obstetric and gynecologic bulletins were similar (P > .05 for comparison of levels I, II, and III and meta-analysis references).Conclusion Only 29% of the American College of Obstetricians and Gynecologists recommendations are level A, based on good and consistent scientific evidence. Suneet P. Chauhan http://jdc.jefferson.edu/obgynfp/1 http://jdc.jefferson.edu/obgynfp/1 Thu, 13 Jul 2006 06:19:34 PDT Objective structured assessments of technical skills (OSATS) are structured operating room or laboratory assessment of residents' surgical skills. They can be used to evaluate and teach both basic and complex skills to residents. The literature on their use is reviewed. Future use of virtual reality simulators is discussed. Carmen J. Sultana