DEPARTMENT OF OBSTETRICS & GYNECOLOGY Annual Report for Academic Year 2009–2010
Warren Alpert Medical School of Brown University THIS REPORT ENCOMPASSES THE PERIOD FROM JULY 1, 2009 THROUGH JUNE 30, 2010. TABLE OF CONTENTS From the Chair Hospital-Based Faculty Community-Based Faculty Residents Ambulatory Care Gynecologic Oncology Maternal Fetal Medicine Medical Education Reproductive Endocrinology & Infertility Research in Women’s Health Urogynecology & Reconstructive Pelvic Surgery Emergency Ob/Gyn Nurse Midwifery Grand Rounds
CONTACT INFORMATION FOR THE DEPARTMENT OF OBSTETRICS & GYNECOLOGY pages 2–3 pages 4–5 page 6 page 7 pages 8–19 pages 21–49 pages 50–65 pages 66–73 pages 74–84 pages 85–105 pages 106–118 pages 119–122 pages 123–131 pages 132–133
Publication Credits: Produced by the Department of Obstetrics & Gynecology Chris Fruggiero, MS, Director of Administrative Operations Designer: Kristen O’Grady, Inkwell Communications (InkwellCommunications.com) Principal Photography: Al Weems (alweemsphoto.com)
Joanna M. Cain, MD Chace/Joukowsky Professor and Chair Obstetrician & Gynecologist-in-Chief, Women & Infants Hospital of Rhode Island (401) 274-1122, ext. 1575 Kathleen C. Bowling, MD, Vice Chair (401) 274-1122 ext. 1575 Gary Frishman, MD, Residency Program Director (401) 274-1122, ext. 1845 Chris Fruggiero, MS Director, Administrative Operations (401) 274-1122, ext. 1577 B. Star Hampton, MD, Clerkship Program Director (401) 274-1122, ext. 1805 Pablo Rodriguez, MD Associate Chair, Community Relationships (401) 274-1122 ext. 1575
NOTE FROM THE CHAIR I grew up in the pioneering tradition of Western Universities—large, land-grant based that have as their mission advancing the welfare of the citizens of the state. It is interesting to now live in the smallest state and be part of a very special but also private University—Brown—and perhaps an even more special institution, a true Women & Infants hospital. Yet, even though private, the mission of the Alpert School of Medicine and that of WIH is focused on the welfare of the citizens of the state of RI and southern New England in often more ways than those Universities dedicated to their state, but also ways that transcend these borders to touch lives throughout the world in as robust a calling to serve as formed the Western Universities. The ESCHUCHE grant—a grant to provide a “curriculum” in health literacy through the vehicle of Latino Public Radio will not only provide guidance and education for women and families in RI, but also provide a template for the entire nation. The work done in MFM to understand H1N1, prematurity, or Maternal Fetal Medicine Units Network based research helps the large volume of women served here—and also far beyond. The development of the Center for Biomarkers and Emerging Technology in Women’s Cancers along with the increasing prominence of the Women’s Cancers’ group as Gynecologic Oncology Group (GOG) leaders again touches women in the region and far beyond. The research in Reproductive Endocrinology may provide options for women with 2
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cancer to keep their fertility, an option that never existed. Clearly every division of the Department of Obstetrics and Gynecology is providing care and research that will improve the lives of women and girls—you only have to read a little about each to understand that. Keeping focus on the spiraling benefits of research and education for women and for the future at a time of great turmoil and competition for scarce resources in medicine will be the true task we face if we are to continue to meet the great calling to serve that has founded the Department , Women & Infants, and Brown. This will be the task that the generations now and in the future will have to face with creativity and fortitude. In some ways, we are forging a path in a new wilderness as broad and uncharted as the western migration and with as many pitfalls and potential threats. But the vistas and new territories that will open to us are unimaginable and beautiful beyond words, and the opportunities to meet our calling in the new world of health care reform even more critical than ever. Forward ho!
Joanna M. Cain, MD Chace/Joukowsky Professor and Chair Obstetrician & Gynecologist-in-Chief, Women & Infants Hospital of Rhode Island
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ADMINISTRATIVE ROLES WITHIN THE DEPARTMENT
Kathleen C. Bowling, MD Vice Chairperson, Department of Ob/Gyn
Pablo Rodriguez, MD Associate Chair, Community Relationships
James O’Brien, MD Medical Director, Inpatient Obstetrics
Gary Wharton, MD Medical Director, Surgical Services
DEPARTMENT OF OBSTETRICS AND GYNECOLOGY HOSPITAL-BASED FACULTY JULY 1, 2009 – JUNE 30, 2010 BROWN APPOINTMENTS PROFESSOR
ASSOCIATE PROFESSOR (CLINICAL)
Eli Adashi, MD John E. Buster, MD Joanna Cain, MD Stephen R. Carr, MD (7/1/2010) Sandra A. Carson, MD Donald R. Coustan, MD Susan Cu-Uvin, MD (joint appt w/Internal Medicine) Gary Frishman, MD Cornelius O. Granai, MD Deborah Myers, MD Dwight Rouse, MD Patrick J. Sweeney, MD, PhD Katharine Wenstrom, MD
Robert Berry, MD (Pending) Robert Legare, MD
ASSOCIATE PROFESSOR (JOINT APPT) Don Dizon, MD (7/1/2010) (with Internal Medicine) Lucia Larson, MD (with Internal Medicine)
ASSOCIATE PROFESSOR (RESEARCH) Cynthia Rosengard, PhD
PROFESSOR (JOINT APPT)
CLINICAL ASSOCIATE PROFESSOR
Francois I. Luks, MD (with Surgery & Pediatrics) Karen Rosene-Montella, MD (with Internal Medicine) Raymond O. Powrie, MD (with Internal Medicine)
Andrew Blazar, MD Donna LaFontaine, MD (7/1/10) Carol Wheeler, MD
ASSISTANT PROFESSOR Rebecca Allen, MD Brenna Anderson, MD Christina Bandera, MD Laurent Brard, MD Ed Chien, MD Sarah Fox, MD Vinita Goyal, MD Brittany Star Hampton, MD Kristen Matteson, MD Carolyn McCourt, MD Barbara O’Brien, MD
CLINICAL PROFESSOR Diane Angelini, EdD, CNM (7/1/2010)
ASSOCIATE PROFESSOR Paul DiSilvestro, MD Richard Moore, MD Maureen Phipps, MD Charles Rardin, MD (7/1/2010)
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DEPARTMENT OF OBSTETRICS AND GYNECOLOGY HOSPITAL-BASED FACULTY JULY 1, 2009 – JUNE 30, 2010 BROWN APPOINTMENTS
ASSISTANT PROFESSOR
TEACHING ASSOCIATE
(CONTINUED)
Erin Dobson, RNP Julie Slocum Daley, RN
Kelly Pagidas, MD Jared C. Robins, MD Katina Robison, MD Ashley Stuckey, MD (8/1/10) Vivian Sung, MD Trevor Tejada-Berges, MD
ASSISTANT PROFESSOR (CLINICAL) Amy Gottlieb, MD Tanya Dailey, MD David Edmonson, MD (7/1/2010) Robin Gray-Puleo, MD Amy Snyder, MD
INSTRUCTOR (CLINICAL) Moune Jabre-Raughley, MD Roxanne Vrees, MD Emily White, MD
CLINICAL INSTRUCTOR Bachir Sakr, MD Joanna Schwartz, PhD
ASSISTANT INSTRUCTOR
Margaret Miller, MD (with Internal Medicine)
Aine Clements, MD Agatha Critchfield, MD Beth Cronin, MD Jennifer Kang, MD Nicole Korbly, MD Katherine Melzer, MD Laura Richio, MD
CLINICAL ASSISTANT PROFESSOR
TEACHING FELLOW
Balasubramanian Bhagavath, MD Cassandra Carberry, MD Matthew Esposito, MD Alfredo Gil, MD Elisabeth Howard, PhD, CNM Linda A. Hunter, EdD, CNM James J. O’Brien, MD Michael J. Paglia, MD Martha Pizzarello, MD Beth Plante, MD Brenda Roy, MD, PhD Jeannine Witmyer, PhD
Julie Johnson, MD Nada Kawar, MD Shannon MacLaughlan, MD Peter Klatsky, MD Katrin Kristijandoittir, MD Sonali Pandya, MD Matthew Rogalski, MD Nicole Sprawka, MD Roman Starikov Ashley Stuckey, MD Wendy Vitek, MD Blair Washington, MD Kyle Wohlrab, MD
ASSISTANT PROFESSOR (JOINT APPT)
CLINICAL ASSISTANT PROFESSOR (JOINT)
RESEARCH FELLOWS
Jennifer S. Gass, MD (with Surgery)
Stephan Krotz, MD
SENIOR TEACHING ASSOCIATE
FELLOWS GRADUATED 6/30/2010
Anne Cooper, RPN, MS Edie McConaughey, MSN, CNM Linda Moulton, RNP, MS (10/1/2010) Patricia O’Connell, RNC Janet Singer, MSN, CNM (10/1/2010) Linda Steinhardt, MS, CNM Ann Stulik, NP (10/1/2010)
Julie Johnson, MD Ashley Stuckey, MD Kyle Wohlrab, MD
RESEARCH ASSOCIATE Amy S. Cooper, CRN, MSN, RNC Christina Raker, ScD (continued)
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DEPARTMENT OF OBSTETRICS AND GYNECOLOGY COMMUNITY-BASED JULY 1, 2009 – JUNE 30, 2010 BROWN APPOINTMENTS
ASSOCIATE PROFESSOR
Karen McGoldrick, MD Kathryn D. McGowan, MD Carroll Medeiros, MD John Murphy, MD (Emeritus) Laura Nevel, MD J. Douglas Nisbet, II, MD Maria O’Toole, MD Michael Pepi, MD Adrienne Perry, MD Marilyn Powers, DO Donald Ramos, MD Rebecca Randall, MD Robert Salk, DO Mark Scott, MD Jane Sharp, MD Santina Siena, MD Meera Simeos, MD Serena Sposato, MD Marshall Taylor, MD (Emeritus) Jacqueline Tetreault, MD Benjamin Vogel, MD W. Scott Walker, MD Gary Wharton, MD Doreen Wiggins, MD
Jennifer G. Clarke, MD Melissa Clarke, MD
CLINICAL ASSOCIATE PROFESSOR Kathleen Bowling, MD Terrence Cahill, MD Wayne Clairborne, MD Steven Falkenberry, MD Kathleen Fitzgerald, MD Tawfik Hawwa, MD Nabil Khoury, MD (7/1/10) John Lathrop, MD (Emeritus) Henry Magendantz, MD Samir Moubayed, MD (Emeritus) Frank Pensa, MD Pablo Rodriguez, MD Reza Shah-Hosseini (Emeritus) Marguerite Vigliani, MD Robert Williams, MD
CLINICAL ASSISTANT PROFESSOR M. David Beitle, MD John Bert, MD Lisa Boyle, MD Debra Brendel, MD Cheryl Brodsky, MD Fred A. Brosco, MD David Carcieri, MD Colleen Cavanaugh, MD Kue Chung Choi, MD Mauro Colavita, MD Jeannine Connolly, MD Joseph DeMartino, MD Mary C. DeRosa, MD John DiOrio, MD Lisa Domagalski, MD Renee R. Eger, MD Harris Galkin, MD Michele Gange, MD Howard Hall, MD (Emeritus) Cynthia Hanna, MD David Harrington, MD Jennifer Hosmer, MD Michelle L. Hughes, MD Marc Jaffe, MD AnnMarie Jurczak, MD Erica Klein, MD Stacey Lievense, MD Beth Marcaccio, MD 6
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ASSISTANT PROFESSOR (CLINICAL) Robert Cohen, DO
CLINICAL INSTRUCTOR Jennifer Boyle, MD Constance Brennan, MD Christine Brousseau, MD Dilek Cermik, MD Michael Coppa, MD (2/1/10) Rebecca Crichton, MD Suzanne Dambek, MD Kathryn Davis, MD Paula DeYoung, MD Beata DiZoglio, MD Debra Goldman, MD Anne Murray, MD Adelaide Nardone, MD Gretchen Paranya, MD Jessica Salak, MD (1/1/10) Alejandra Turmero, MD Anne Wold, MD
INSTRUCTOR (ADJUNCT) Ali, M. F. Moustafa (7/1/2010) o f
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BROWN UNIVERSITY/WOMEN & INFANTS HOSPITAL OF RHODE ISLAND OBSTETRICS AND GYNECOLOGY RESIDENTS PGY-1 (2008-2012)
MEDICAL SCHOOL
Catherine Albright
Columbia University College of Physicians and Surgeons
Kathaleen (Gravel) Barker
University of Connecticut School of Medicine
Lindsay Clark
Brown Medical School
Luu Doan
University of California, Los Angeles, David Geffen School of Medicine
Terri Febbraro
Albert Einstein College of Medicine/Yeshiva University
Karen Gibbins
Case Western Reserve University School of Medicine
Kavita Mishra
University of California, San Francisco SOM
Dario Roque
University of Florida School of Medicine
PGY-2 (2007-2011)
MEDICAL SCHOOL
Elizabeth (Carlisle) Cappelletti Northwestern University Jacquia Fenderson
University of Rochester School of Medicine
Melanie Greenman
Duke University School of Medicine
Megan McCoin
University of Texas Medical School- San Antonio
Jeannine Miranne
Albany Medical College
Kristina Mori
Tufts University School of Medicine
J. Pablo Orezzoli
University of Buenos Aires School of Medicine
PGY-3 (2006-2010)
MEDICAL SCHOOL
Archabald, Karen
Yale University School of Medicine
Baker, Julie
State University of New York - Buffalo
Carey, Molly
University of Pennsylvania
Holman, Laura
University of Illinois
Jackson, Amanda
Medical University of South Carolina
Kassis, Nadine
Medical University of Ohio
McDonnold, Mollie
Baylor College of Medicine
McMahon (Reynolds), Megan University of Massachusetts PGY-4 (2005-2009)
MEDICAL SCHOOL
Clements, Aine
Brown Medical School
Critchfield, Agatha
University of Kentucky College of Medicine
Cronin, Beth
University of Vermont College of Medicine
Kang, Jennifer
University of Rochester School of Medicine
Korbly, Nicole
University of Massachusetts Medical School
Melzer, Katherine
State University of New York–Buffalo, School of Medicine
Sacco, Laura
University of Massachusetts Medical School
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Ambulatory Care
DIVISION OF AMBULATORY CARE MISSION The Division of Ambulatory Care in the Women’s Primary Care Center (WPCC) is dedicated to the following goals: 1.
To provide high quality, comprehensive outpatient services to all women. We offer women’s Primary Care, Prenatal Care, and Gynecologic Care. In addition, specialty services are offered in the following areas: Colposcopy, Vulvar Disorders, Chronic Pelvic Pain, complete Family Planning, Urogynecology, Reproductive Endocrinology, Pediatric Gynecology, Substance Abuse Counseling and Treatment, Nutritional Counseling, Social Service, Ultrasound, and Fetal Evaluation.
2. To educate medical students, residents, and other health profession students in women’s primary care, with emphasis on the screening, diagnosis, treatment, and follow–up of problems in the ambulatory setting. 3. To conduct research in areas related to women’s primary care and reproductive health issues. 4.
To serve as a tertiary outpatient center for patients referred by other primary care providers for specialized assessment and treatment of substance abuse in pregnancy, cervical dysplasia, benign vulvar conditions, pediatric gynecology, urogynecology, reproductive endocrinology, contraception in women with complex medical problems, and chronic pelvic pain.
FACULTY Patrick J. Sweeney, MD, PhD, Division Director BS: Loyola University MD: St. Louis University Residency: Temple University MPH: University of California, Berkeley PhD: University of Mississippi Dr. Sweeney is a Professor of Obstetrics and Gynecology and the Director of the Division of Ambulatory Care with overall responsibility for the administration of the WPCC. He joined the faculty in 1987 after having served for nine years as the Assistant Director of Ambulatory Care for the University of Tennessee College of Medicine. Early in 1995, Dr. Sweeney was appointed Associate Chair for the Department of Ob/Gyn, representing the department at academic functions when the chair is not available. In addition, he is an Associate Dean of Medicine for Continuing Medical Education for the Brown Medical School. Dr. Sweeney is an active member of the American College of Obstetricians and Gynecologists, having been appointed to several national committees in addition to serving two terms as Treasurer of District I. He is a reviewer for Obstetrics and Gynecology and serves as an Editorial Board Member for Medicine and Health - Rhode Island. On April 30, 2010, Dr. Sweeney stepped down to assume the role of Designated Institutional Official and CME Director at Women & Infants Hospital. 8
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Robert E. Berry, Jr, MD, Incoming Division Director BA: Williams College MD: University of Virginia School of Medicine Residency: Tufts University Affiliated Hospitals Dr. Berry is a Clinical Associate Professor of Obstetrics and Gynecology and the new Director of the Division of Ambulatory Care effective May 1, 2010, with overall responsibility for the administration of the WPCC. He joined the faculty in 2010 after having been at the University of Massachusetts Medical School and UMass Memorial hospitals for ten years. He served there as the residency program director among other capacities. He began his career at Tufts New England Medical Center where he was a member of the Generalist Division and he served as the clerkship director. His professional interests include medical education, technology and patient care, and medical professionalism. Rebecca H. Allen, MD, MPH BA: Wesleyan University MD: College of Physicians and Surgeons, Columbia University MPH: Mailman School of Public Health, Columbia University Residency: Brigham and Women’s Hospital/Massachusetts General Hospital, Harvard University Fellowship: Brigham and Women’s Hospital, Harvard University Dr. Allen is an Assistant Professor of Obstetrics and Gynecology and Director of Family Planning for the Women’s Primary Care Center. After completing a fellowship in Family Planning, she joined the Division of Ambulatory Care in 2007. Dr Allen directs the Department’s Reproductive Health Rotation and the Core Curriculum series in General Gynecology. Since joining the division her roles have included supervising medical students, residents and nurse practitioners in the WPCC, including the Colposcopy Clinic and Contraception Consult Clinic. She also coordinates the Rhode Island Hospital Internal Medicine Residency Program Subspecialty Rotation in Gynecology at the WPCC. Sarah D. Fox, MD BS: Brown University MD: Robert Wood Johnson Medical School (University of Medicine and Dentistry of NJ) Residency: Allegheny University/Allegheny General Hospital Fellowship: St. George’s Hospital, University of London Dr. Fox is an Assistant Professor of Obstetrics and Gynecology. After completing a fellowship in Urogynecology and Pelvic Floor Reconstruction, she was in private practice in Rhode Island and a community-based faculty member at Women & Infants Hospital of Rhode Island for 4 (continued)
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years. Since joining the division, her roles have included supervising medical students, residents and nurse practitioners in the Women’s Primary Care Center. She is director of the Colposcopy Clinic and also directs a multidisciplinary Virtual Chronic Pelvic Pain clinic with specialists from Anesthesia, Physiatry, Behavioral Health, Gastroenterology, and Physical Therapy. In 2004, she received a Kenneth J. Ryan Training Grant in Abortion and Family Planning from the Kenneth J. Ryan Program and established a family planning curriculum. Amy S. Gottlieb, MD AB: Harvard University MD: University of Chicago Pritzker School of Medicine General Internal Medicine Residency: Brown University/RI Hospital Dr. Gottlieb is an Assistant Professor of Medicine and Obstetrics and Gynecology (Clinical) and the Director of Primary Care Curricula and Consultation in the Women’s Primary Care Center. Dr. Gottlieb directs the Department’s Ambulatory Care Medicine Rotation and the Core Curriculum Series in Primary Care Internal Medicine. She also precepts medical students, residents, and nurse practitioners in the Women’s Primary Care Center and conducts a consultative Internal Medicine clinic. In addition to curriculum development, Dr. Gottlieb’s academic pursuits include educating health care professionals about violence against women and mentoring women in medicine. To this end, she is the Chairperson of the Women & Infants Hospital Domestic Violence Task Force, an appointed member of Brown Medical School’s Office of Women in Medicine and Science Advisory Board and its Medical Committee on Academic Standing, and is Co-Director of MomDocFamily, a nationwide mentoring organization of physicians who are mothers. Vinita Goyal, MD BA: University of Washington MD: University of Washington School of Medicine Residency: University of Texas Health Science Center at San Antonio MPH: University of North Carolina Fellowship: University of North Carolina Dr. Goyal is an Assistant Professor of Obstetrics and Gynecology for the Women’s Primary Care Center. After completing a fellowship in Women’s Health Research, she joined the Division of Ambulatory Care in 2009. Since joining the division her roles have included supervising medical students, residents and nurse practitioners in the WPCC, including the Colposcopy Clinic and Contraception Consult Clinic. She also directs the Gynecologic Consult Clinic at the WPCC.
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Anne Stulik, MSN, WHCNP BSN: University of RI MSN: State University of New York at Buffalo Anne Stulik joined the department in 1986 after working for three years as an Ob/ Gyn nurse practitioner for Health Care Plan of Western New York. Previously, she spent two years as an American Peace Corps volunteer working in women’s health. She completed her Master’s degree from SUNY Buffalo in 1983 and is certified through the NCC as a Woman’s Health Care Nurse Practitioner. She has a special interest in adolescents and follows pregnant teenagers in the WPCC’s adolescent prenatal clinic. Teaching responsibilities include Brown medical students, for which she received a Brown University Medical School Excellence in Teaching award. Patricia O’Connell, MS, WHCNP BSN: Seattle University MS: Boston College Patricia O’Connell joined the department in 1987 after completing her Masters program in Women’s Health at Boston College. She is certified as a Women’s Health Care Nurse Practitioner and as a Nurse Colposcopist. In addition to general obstetric and gynecologic care, her interests include colposcopy and caring for adolescents. Patricia teaches Brown Medical students, and is a Clinical Preceptor for both the University of Rhode Island and Boston College’s Nurse Practitioner programs. Patricia is a member of the American Society for Colposcopy and Cervical Pathology and the Association of Reproductive Health Professionals. Linda Moulton, MSN, FNP BA: Brown University BSN: Newport Hospital School of Nursing MSN: University of RI Linda Moulton has been a primary care nurse practitioner at the WPCC since 1992. She graduated from Brown in 1971 and went on to teach German, mathematics and ancient history at St. George’s School in Newport, RI and the Shipley School in Bryn Mawr, PA. After completing her nursing degree in 1983, she worked for four years as a staff nurse at the Providence VNA. In 1989, she graduated as a family nurse practitioner from URI. She was certified in colposcopy in 1993 by The University of Pennsylvania and Planned Parenthood of Southeastern Pennsylvania and also has an interest in dermatology. Linda has received numerous excellence in teaching awards since 1992 in her role as a Clinical Instructor for Brown medical students. Linda speaks Spanish and German and is a member of the ASCCP and NPRH. (continued)
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NURSE PRACTITIONERS
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Erin Dobson, MSN, FNP BSN: New York University MSN: University of RI After graduating from NYU in 1981, Erin Dobson worked as a staff nurse for ten years in labor and delivery, surgery and drug and alcohol rehabilitation prior to obtaining her master’s degree in 1992. She is certified as a family nurse practitioner and joined the staff at the WPCC in 1992. In addition to her teaching of Brown medical students, Erin is a clinical preceptor for the University of Rhode Island Nurse Practitioner program. Erin earned the Dean’s teaching excellence award last year and has received numerous excellence in teaching awards since 1992. Paulette Corey, MSN, FNP BSN: University of RI MSN: University of RI After working in a community health center for three years as well as working in research at Memorial Hospital with the Women’s Health Initiative, Paulette joined the department of obstetrics and gynecology in 1995. She has a special interest in STDs and pregnancy prevention, and while employed at WIH has worked in the Division of Research performing women’s health research. In the WPCC, Paulette is involved with teaching medical students and has precepted nurse practitioner students in the past. She is now involved in the Vulvar Specialty Clinic with a specialty in patients with recurrent vaginitis. Ann Biderman Cooper, RNP, MS BS: Skidmore College MSN: University of California, San Francisco After a number of years working as Nurse practitioner in an OB/GYN practice, Ann Cooper returned to Women & Infants in 2002 to work with OB Medicine as a Research nurse and since 2004 at the WPCC as a Nurse practitioner. Following college and a stint in Boston, Ann worked in San Francisco and completed a Master’s/NP program at UCSF. She then worked at San Francisco General Hospital as an NP/Research nurse in GYN Infectious Disease. After moving home to RI in 1979, Ann worked at the Women & Infants Ambulatory Care Center on Maude Street until 1985. During this time she also served as a Captain in the US Army Reserves. She is certified as a Women’s Health Care Nurse Practitioner, speaks Spanish, and has a special interest in adolescent and refugee health.
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Ann Holdredge, CNM, FNP RN: St. Joseph’s Hospital BSN: Salve Regina University FNP: Northeastern University MSN/CNM: University of RI Ann Holdredge returned to the department in 2008 after working as a nurse midwife in a private Ob/Gyn practice in Rhode Island as well as the Indian Health Services in Gallup, New Mexico. She has precepted both Brown and Yale medical students as well as nurse practitioner and nurse midwife students from the Universities of RI, Vermont and New Mexico. She has an interest in cultural aspects in women’s health care.
CLINICAL ACTIVITY: THE WOMEN’S PRIMARY CARE CENTER The Division of Ambulatory Care conducts a variety of general and specialized outpatient sessions at the Women’s Primary Care Center (WPCC). The WPCC’s volume for 2009 fiscal year was 33,879 patient encounters. The types of sessions and the times they are held are outlined in Table 1. Our clinical services include prenatal and postpartum care, family planning, general gynecology, pre-operative consultation, and primary/preventive health care services such as immunizations, age-appropriate health screening and annual examinations. Specialty clinics in colposcopy, vulvar disorders, chronic pelvic pain, contraception for women with complex medical problems, and early pregnancy termination are also offered. Supervision for clinical sessions is provided by members of the division as well as by hospital-based and communitybased faculty from the departments of Ob/Gyn and Internal Medicine. Dr. Gottlieb, our general internist, also conducts regular medicine consultation clinics. Faculty from the subspecialty of Maternal-Fetal Medicine attends the Diabetic and High Risk prenatal sessions (designated “GDM” and “MFM” respectively, in Table 1). Table 1. Ob/Gyn Ambulatory Care Division Outpatient Schedule Monday Tuesday Wednesday AM
Friday • WPCC
• WPCC
• WPCC
• WPCC
• WPCC
• Internal
• Contraception
• Adolescent
• Depo Provera
Medicine Consult Clinic • Colposcopy Test Results
PM
Thursday
Consult Clinic • MFM • Therapeutic
Prenatal Clinic • Yellow Chart Clinic (MFM)
• MFM • LEEP • OR (OR LEEPS, colpo and
Abortion Clinic
• MFM
• Vulvar
• WPCC
• WPCC
• WPCC
• WPCC
• WPCC
• Early Options
• Chronic Pelvic
• Gyn Consult
• Colposcopy
• Pediatric
Clinic
Pain • MFM • Internal Medicine Consult Clinic
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Clinic • Gyn Specialty Clinic • Colposcopy
• Pelvic Pain
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• Urogyn
• Internal
• REI
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The second and third year fellows in the fellowship in Female Pelvic Medicine and Reconstructive Surgery offer urogynecology services at the WPCC twice monthly which provides the fellows with more independent clinical care, decision making, and practice management. Case review is provided by the Division of Urogynecology faculty. Fellows from the Division of Reproductive Endocrinology and Infertility see patients at the WPCC and address problems such as infertility, PCOS, menorrhagia, menopausal issues and other endocrine disorders. They are supervised by the Reproductive Endocrinology and Infertility faculty. The majority of the patients receiving sub-specialty care are referred by other WPCC providers but our services are open to all referring providers. A separate session in pediatric and adolescent gynecology meets weekly and is staffed by faculty from REI and from the community-based practices. The WPCC is located at 2 Dudley Street on the fifth floor of the Medical Office Center (MOC). Located one block from the hospital, the MOC is connected to the main hospital building by a bridge and passageways through Rhode Island Hospital. Our facility includes 18 general examination rooms and 4 special procedure rooms. One of the rooms is equipped with a ceiling lift to allow safe transfer of patients who need this accommodation. There are eight consult rooms, a conference room, and offices for nurse practitioners, social workers, and family planning counselors. Nutritionists are located directly across the hall, and a satellite lab provides phlebotomy services directly adjacent to the WPCC. The academic offices of the Division of Ambulatory Care are onsite, allowing faculty immediate access to the clinical area. The WPCC also has on-site formal ultrasound, staffed by the Department of Radiology, and a fetal evaluation unit. The WPCC attempts to maintain provider continuity as much as possible. First established fourteen years ago, the concept of continuity has markedly improved both patient and provider satisfaction. In the last years, provider continuity occurred during 90% or more of all prenatal visits. In an attempt to be more responsive to the primary care needs of our patients, we instituted “walk-in” sessions in the WPCC ten years ago. These appointment slots are reserved for patients with urgent (but not emergent) complaints for which they would otherwise have to go to an emergency room. WPCC nurses staff a ‘nurse line,’ a telephone line to our patients and the community to answer clinical questions and triage patients’ medical complaints. In the past year, we registered over 10,290 calls. In addition, our Family Planning counselors handled over 5,000 phone calls from patients requesting information on contraceptive services.
PEDIATRIC AND ADOLESCENT GYNECOLOGY CLINIC The pediatric and adolescent gynecology clinic began in July of 2006 to serve the needs of the girls in Rhode Island and Southeastern Massachusetts with gynecologic issues and concerns. The other focus of the clinic is to provide an educational experience for the Women & Infants Hospital of Rhode Island obstetrics and gynecology residents. The clinic initially met twice a month on Friday afternoons, but now meets every Friday afternoon. Attending staff include
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Dr. Evelyne Caron. Patients have been seen in the clinic as young as infants to as old as 16 years, although in general the upper age limit is 14 years. The goal has been to focus on the younger child who is not sexually active. Older girls seeking routine gynecologic care or contraception are referred to the WPCC or private gynecologists. Several surgical procedures have been done on patients seen in the clinic, although the bulk of the patients are primarily office based. Follow up care is provided for girls seen in both the Women & Infants Emergency Room and Hasbro Children’s Hospital Emergency Room. Problems commonly encountered include pediatric vulvovaginitis, lichen sclerosis, labial adhesions, pelvic pain, dysfunctional bleeding, dysmenorrhea, congenital anomalies, ovarian cysts, and amenorrhea. The referring providers have received communication by letter after every visit. Feedback from the patients has been positive and the residents have found it to be a valuable educational experience.
RESEARCH ACTIVITY: THE WOMEN’S PRIMARY CARE CENTER The WPCC is a recruitment site for multiple clinical research studies for faculty and resident research projects. The types of studies conducted range from the Maternal Fetal Medicine Unit’s Network trials to research in postpartum depression and maternal antidepressant use from the Center for Women’s Behavioral Health. Research is conducted by most of the divisions of the Department of Obstetrics and Gynecology and is often performed in concert with the Division of Research. In addition, the faculty of the Division has conducted studies ranging from mindfulness meditation for women with chronic pelvic pain to interventions for pain control during intrauterine device insertion, and screening for intimate partner violence.
EDUCATIONAL ACTIVITIES Faculty members in the Division of Ambulatory Care actively participate in the education of medical students, nurse practitioner students, residents and faculty. As there continues to be an increasing emphasis on outpatient treatment, future health care professionals need to be prepared to deal with this trend. All Ob/Gyn physician faculty members serve as faculty preceptors for medical students during the 3rd year Ob/Gyn clerkship (BioMed 490) and most participate as lecturers during the clerkship on a variety of topics. In terms of resident education, all faculty members participate in the gynecology noon conferences, as preceptors, and all give lectures as part of core curriculum. Other faculty teaching assignments and educational activities include: Allen, RH Director and Faculty Lecturer, Core Curriculum Series in General Gynecology, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University (continued)
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Dr. Carol Wheeler (director), Dr. Jackie Tetreault, Dr. Carroll Medeiros, Dr. Suzanne Dambek and
Ambulatory Care
Faculty Preceptor, Rhode Island Hospital Internal Medicine Residency Program Subspecialty Rotation in Gynecology, Alpert Medical School, Brown University Co-Director for Women’s Reproductive Health, Freedom and Rights Scholarly Concentration, Alpert Medical School, Brown University Faculty Mentor: Resident Colposcopy/Vulvar/Gynecology Conference; Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Director, Ryan Program for Resident Education in Family Planning, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Resident Research Advisor, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Resident Physician Advisor, Department of Obstetrics and Gynecology, Alpert Medical School, Brown University Fox, SD Faculty Mentor, Coordinator: Resident Physician Weekly Colposcopy/Vulvar/Gynecology Conference, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Medical Student Mentor, Office of Community Health, Alpert Medical School, Brown University Adjunct Assistant Professor in Gender Studies: GNSS0900C – Reproductive Health: Science and Politics, Freshman Seminar, Brown University Director, Colposcopy Clinic and Resident Colposcopy Rotation, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Faculty Lecturer, Core Curriculum Series in General Gynecology, Obstetrics and Gynecology Residency, Albert Medical School, Brown University Gottlieb AS Director and Faculty Preceptor, Ambulatory Care Rotation, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Director and Faculty Lecturer, Core Curriculum Series in Primary Care Internal Medicine, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Faculty Supervisor, Primary Care Noon Conference, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University
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Faculty Lecturer, General Internal Medicine Residency, Alpert Medical School, Brown University (Rhode Island Hospital) Resident Research Advisor, Obstetrics and Gynecology Residency, Alpert Medical School, Brown University Research Advisor: Scholarly Concentration Project (Medical Education); Resident Physician Advisor, Department of Medicine, Alpert Medical School, Brown University Medical Student Mentor, Office of Women in Medicine, Alpert Medical School, Brown University
REGIONAL COMMITTEES Fox SD Lobbying Team Member, Planned Parenthood of RI Executive Board of RI National Organization of Women Program Coordinator of Healthy Kids RI: The Campaign for Comprehensive Sex Education in RI Gottlieb AS Chair, Domestic Violence Task Force, Women & Infants Hospital of Rhode Island Advisory Board, the Office of Women in Medicine, Alpert Medical School of Brown University Advisory Board, Gender and Sexuality Studies, Brown University Co-Director, MomDocFamily
NATIONAL COMMITTEES Fox SD Board of Directors, International Pelvic Pain Society Chair, Medical Education Committee, International Pelvic Pain Society Gottlieb AS Invited Member, Women’s Health Task Force, Society of General Internal Medicine Allen RH Chair, Contraception Special Interest Group, American Society for Reproductive Medicine
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PUBLICATIONS, ABSTRACTS, & PRESENTATIONS RE BERRY, MD AWARD CREOG National Faculty Award for Excellence in Resident Education from the University of Massacusetts. POSTER PRESENTATION Tassone,G.M., Moore Simas, T.,Berry, R.E. Jr Gestational Weight Gain – How to ‘Institute’ New Guidelines. Poster Presentation, American College of Obstetricians and Gynecologists 58th Annual Clinical Meeting, San Francisco, CA, 5/2010. PUBLICATIONS Moore Simas T , Riza L, Pasquale S, Berry Jr R, Manning M, Tasillo D, Fluid Resuscitation and Blood Product Replacement in Postpartum Hemorrhage. MedEdPORTAL; 2010. Available from: http://services.aamc.org/30/mededportal/servlet/s/segment/mededportal/?subid=7919 Tasillo D , Moore Simas T, Riza L, Pasquale S, Berry Jr R, Manning M, Pharmacologic Interventions in Postpartum Hemorrhage. MedEdPORTAL; 2010. Available from: http://services.aamc. org/30/mededportal/servlet/s/segment/mededportal/?subid=8024
AS GOTTLIEB, MD PUBLICATIONS Kang JA, Gottlieb AS, Raker CA, Aneja SS, Boardman LA. Interpersonal violence inquiry with standardized health prevention screening. Obstetrics & Gynecology. 2010;115:1159-65. Aneja S, Gottlieb AS, Feller E. Physician intervention for intimate partner violence. Medicine & Health/Rhode Island. 2009;92:307-309 Lechner BE, Gottlieb AS, Taylor LE. Effectively mentoring physician-mothers. (Letter) Academic Medicine. 2009;84:1643-1644. ABSTRACTS Taylor J, MacNamara M, Gottlieb AS. MomDocFamily – providing mentoring and support to physician-mothers. Oral presentation at The Society of Teachers of Family Medicine Northeast Region Meeting, Rye Brook, New York, November 1, 2009. MacNamara, M, Gottlieb AS, Taylor J. MomDocFamily – An innovative strategy for physicianmother workforce development and retention. Seminar at The National Area Health Education Center (AHEC) Organization 2010 Conference, Las Vegas, Nevada, June 22, 2010. INVITED LECTURES, WORKSHOPS, AND PANELS Intimate Partner Violence: A Practical Guide for Clinicians: Recognizing & Assisting Female Patients Experiencing Partner Abuse” (Speaker). Grand Rounds, Kent Hospital. Warwick, RI. February 11, 2010. “Intimate Partner Violence: A Practical Guide for Clinicians: Recognizing & Assisting Female Patients Experiencing Partner Abuse” (Speaker). Department of Emergency Medicine, Kent Hospital. Warwick, RI. May 13, 2010. Domestic Violence” (Panel discussant). Physicians for Human Rights, The Warren Alpert Medical School of Brown University. Providence, RI. October 28, 2009.
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“Relationships & Medicine” (Panel discussant). Pre-clinical Advising Program, The Warren Alpert Medical School of Brown University. Providence, RI. March 3, 2010.
RH ALLEN, MD PUBLICATIONS Allen RH, Raker C, Steinauer J, Eastwood KL, Kacmar JE, Boardman LA. Future �������������������� Abortion Provision among United States Graduating Obstetrics and Gynecology Residents, 2004. Contraception 2010;81:531-6. Allen RH, O’Brien B. Uses of misoprostol in obstetrics and gynecology. Reviews in Obstetrics & Gynecology 2009;2:159-168. Hachey KJ, Allen RH, Nothnagle M, Boardman LA. Requiring human papilloma virus vaccine for immigrant women. Obstetrics and Gynecology 2009;114:1135-9. INVITED LECTURES, WORKSHOPS, AND PANELS Allen, RH. “Hormonal contraception: Pills, patches, rings and other things” Rhode Island Hospital, Endocrine Division Grand Rounds. Providence, RI. March 31, 2010. Allen, RH. “Managing Side Effects of Hormonal Contraception” Roundtable Discussion American Society for Reproductive Medicine 65th Annual Meeting, Atlanta, GA. October 2009.
SD FOX, MD ABSTRACTS Chisolm-Straker M, Weinstein S, Fox SD. Abortion Counseling and Informed Consent: A survey of women’s experiences. National Abortion Federation Annual Meeting Philadelphia PA, 4/26/10 INVITED LECTURES, WORKSHOPS, AND PANELS “Reproductive health and inflammatory bowel disease.” Women & Infants’ Hospital of RI Inflammatory Bowel Disease Support Group 9/2/09 “Reducing Pain for Patient and Provider: The initial approach to the chronic pelvic pain patient.” International Pelvic Pain Society Annual Meeting, Phoenix, AZ, 10/16/09 “Surgical Management of Chronic Pelvic Pain” International Pelvic Pain Society Annual Meeting, Phoenix AZ, 10/16/09 “Chronic Pelvic Pain and Reproductive Health.” Brown University Scholarly Concentration in Women’s Reproductive Health and Freedom, 11/12/09 Careers in Women’s Health, Panel Discussion, Brown University MOMS Program, Providence, RI, 2/3/10 “Opioids: The Good, the Bad and the Ugly” Luncheon Conference at ACOG Annual Clinical Meeting, San Francisco, CA, 5/18/10
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Mentoring Relationships” (Panel discussant). Careers in Medicine, The Warren Alpert Medical School of Brown University. Providence, RI. February 5, 2010.
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DIVISION OF GYNECOLOGIC ONCOLOGY The Program in Women’s Oncology is the state’s largest focused cancer program dedicated to women. Since 1989, the Program in Women’s Oncology has evolved from a series of common– sense questions. The central and framing question, which continues to drive the Program, is “What would you want done for your loved ones under those circumstances?” While each of our desires would undoubtedly vary, in the face of a serious health problem such as cancer, we would all want for our loved ones the best science–of–medicine (a.k.a. evidence–based medicine) but is that all? Surely, we as an Oncology Program must provide the best of medical science for the patients and families seeking our care, so let’s consider how that’s done first. Though seemingly straight–forward, in truth, providing the best medical recommendations for an individual is not easy. “Cancer” is in actuality thousands of different diseases, each with its own important, distinctive nuances, treatments, and prognoses. Determining what you have and what are the best medical recommendations for your specific cancer, under your individual circumstances, is in actuality very important and very difficult to do. The Program in Women’s Oncology is dedicated to helping patients understand what they have and what science pertains (a.k.a. – “p–values”) and of those, which medical recommendations are best for them. It does so through the unique, multi–disciplinary Tumor Board process. A core value of the Program, the Tumor Board (i.e. a multidisciplinary, prospective process) assures that the best science of medicine is offered to our patients. The Tumor Board’s charge is to carefully consider the exact type of malignancy each individual patient has and her overall medical circumstances. From that evolves the best medical recommendation for them. Once that recommendation has been conveyed to the patient and fully understood, and assuming the patient and family concur, the next tumor board question is “Where should that recommendation be carried out?” The Tumor Board process, the research program and treatment protocols, the best science of medicine are all extensions of the Program’s answer to the framing question, “What would we want done for our loved ones under those circumstances?” But, as important as the best “p– values” of medicine is for patients, is that all we would want for our loved ones facing cancer? The obvious answer is no, “we would want more”. In addition to the p–values, we want caring, hope, and other “human values.” Therefore, in the sequence of questions guiding the Program in Women’s Oncology is the continuous and always –asked follow–up question, “Can we do more?” Can we do more for the patient than providing the best possible best science of medicine? Asking these series of questions, each step along the way, brings the Program’s cancer care/caring to very different places than would science alone. “P–values,” “H–values”, science, art, and the poetry of life inspire (continued)
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“THE PROGRAM IN WOMEN’S ONCOLOGY”
the Program in the remarkably diverse work that it does on behalf of cancer patients and their
Gynecologic Oncology
families. The Program now has many excellent and comprehensive services/components… from MD’s and PhD’s, to surgery, chemotherapy, music, and poetry; all are interpretations of what we would want done for our loved ones under those circumstances. In the broadest, most philosophic sense, then, the Program is continually challenged by the simultaneously unanswerable and introspective question “What matters matter?”
PROGRAM FACULTY Cornelius O. “Skip” Granai III, MD, FACOG, FACS, Division Director MS: University of Vermont MD: University of Vermont Residency: Tufts Fellowship: New England Medical Center Dr. Granai is a Professor of Obstetrics & Gynecology and the Director of the Gynecologic Oncology Division, as well as Director of the Gynecologic Oncology Fellowship Program. He is also Vice President of Network Development and Women’s Cancer at Women & Infants Hospital of Rhode Island. He heads a multidisciplinary team including residents, nine gynecologic oncologists, four gynecologic oncology fellows, one breast fellow, oncology nurses, nurse practitioners, physician’s assistants, social workers, dieticians, integrative therapy staff, physical therapists, an administrative team and the multi–disciplinary support of many others including medical students from Brown and elsewhere. Prior to joining Women & Infants Hospital of Rhode Island and Brown University, he was on the faculty of Tufts and Harvard University and on the staffs of New England Medical Center and Massachusetts General Hospital where he served as Director of the Gynecologic Oncology fellowship program. He is board certified in Obstetrics and Gynecology and Gynecologic Oncology. He is a fellow of the American College of Surgeons, the Society of Surgical Oncologists, the Society of Gynecologic Oncology, the New England Association of Gynecologic Oncologists, and the American Society of Clinical Oncology. Dr. Granai is the Vice President of the Society for Gynecologic Oncology. He is a member of the International Gynecologic Cancer Society. Dr. Granai holds the title of Oral Examiner for the American Board of Obstetrics and Gynecology, for both Ob–Gyn oral boards and the subspecialty Gyn–Oncology boards. Dr. Granai is the founder of the Integrative Care Program at Women & Infants Hospital of Rhode Island, which began in 1992. This unique, patient–centered program includes pet therapy, massage, reiki, journal writing, yoga, nutrition/weight–loss counseling, personal life history/ writing, music therapy, meditation, hypnotherapy, spa–treatments, acupuncture, art therapy, and more. He is also the Founder and President of the International Health Foundation, which provides ongoing, direct health care and educational exchanges in which physicians and nurses from WIH/Brown and the Dominican Republic visit each other to provide teaching, clinically demonstrate surgical techniques, and share ideas on treatment approaches. 22
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Dr. Granai has served as chairman of the Life Enrichment Task Force of the Society of Gynecologic Oncology. Dr. Granai was honored by being voted “Top Doctor for Women” in the “Best Doctors in America.” Dr. Granai is a recipient of the Lifetime Achievement Award by the American Cancer Society. In addition to all of this, Dr. Granai has become an acclaimed, national speaker, sought after for his real–life medical/surgical experiences, personal experiences, philosophic, humorous, compassionate and always–dynamic presentations. He has been the keynote speaker at numerous, national and international conferences and annual meetings. Christina Bandera, MD BS: Harvard University MD: Johns Hopkins University Residency: Brigham and Women’s Fellowship: University of Pennsylvania Dr. Bandera joined the Program in Women’s Oncology in February 2005 and is Board Certified in General Obstetrics and Gynecology and Gynecologic Oncology by the American Board of Obstetrics and Gynecology. She also completed a Fellowship in Robotic Surgery for Gynecologic Oncology. Dr. Bandera’s clinical interests include the surgical and medical management of gynecologic cancers. She has a special interest in providing minimally invasive surgery. She has published numerous research articles and chapters regarding gynecologic cancers and is currently the Gyn Oncology editor for the international journal Gynecologic and Obstetric Investigation. Dr. Bandera lives in Cranston with her husband Dr. Cedric Priebe. Laurent Brard, MD, PhD MD: University of Pittsburgh Residency: Women & Infants Hospital of Rhode Island Fellowship: Women & Infants Hospital of Rhode Island Dr. Brard joined our Program in July, 2002. Born in Nantes (France), raised in Montreal (Canada) and Paris (France), Dr. Brard has received numerous degrees: BSc in Chemical Engineering from École Supérieure de Chimie Industrielle de Lyon (France), 1987; MSc in Organic Chemistry from Université Claude Bernard (France), 1987; PhD in Chemistry from Northwestern University, 1991; Post-Doctorate fellowship in Chemistry at Northwestern University, 1992; Post-Doctorate fellowship in Chemistry at University of Pennsylvania, 1992-1994; MD from the University of Pittsburgh, 1998. Dr. Brard is a published clinician-scientist with several patents (some through Women & Infants Hospital of Rhode Island/Brown University). Since arriving in Rhode Island, Dr. Brard has continued his academic work with 58 publications, and 70 abstracts to date. Following the completion of this fellowship in June 2005, he was selected by a national search process to begin his faculty appointment as Assistant Professor at the Warren Alpert Medical School of Brown University in the Division of Gynecologic Oncology, and Department of Obstetrics and Gynecology. Shortly thereafter, he was selected as one of four BIRCWH (Building Interdisciplinary Research Careers in Women’s Health) NIH K12 grant (continued)
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Rhode Island Monthly magazine. Dr. Granai was also honored with being elected as one of the
scholars. During his BIRCWH scholarship, he also received a NIH/NINDS R21 grant, an OCRF
Gynecologic Oncology
Foundation grant and Brown University Seed grants. After completing his BIRCWH scholarship, he was recently awarded a NIH/NCI R01 five-year grant. He is currently the director of the Molecular Therapeutics Laboratory, the basic science lab of the division of Gynecology Oncology. Among his other accomplishments is a continued commitment to education. Dr. Brard has received multiple teaching awards from Women & Infants Hospital of Rhode Island and the Warren Alpert Medical School of Brown University School. Dr. Brard is leaving Women & Infants effective June 30, 2010. Paul A. DiSilvestro, MD, FACOG, FACS BA: Dartmouth College MD: University of Vermont Residency: Women & Infants Hospital of Rhode Island Fellowship: University of Oklahoma. Dr. DiSilvestro is an Associate Professor in the Department of Obstetrics and Gynecology at Brown University School of Medicine. He joined our Program in September, 2003. Dr. DiSilvestro is Board certified in Obstetrics and Gynecology and Gynecologic Oncology. He has major research interest in clinical trials and serves as the Principal Investigator at Women & Infants Hospital of Rhode Island for the Gynecologic Oncology Group of the National Cancer Institute. Dr. DiSilvestro has recently been appointed co-chairman of the Ovarian Cancer Committee for the Gynecologic Oncology Group. He is a member of several professional societies, including the Society of Gynecologic Oncology. Dr. DiSilvestro is also the chairman of the Institutional Review Board at Women & Infants Hospital of Rhode Island. Don S. Dizon, MD BA: University of Rochester MD: University of Rochester School of Medicine Residency: Yale-New Haven Fellowship: Cornell University Dr. Dizon joined our Program in October, 2003 as Director of Medical Oncology and is an Assistant Professor of Medicine and Obstetrics & Gynecology for Brown Medical School; currently serves as co-director of the Center for Sexuality, Intimacy and Fertility as well as the Director of Integrative Services. He is board certified in internal medicine and medical oncology. He received the American Society of Clinical Oncology Career Development Award in 2002. He was elected fellow of the American College of Physicians in 2005. He is a member of the American College of Physicians, the American Society of Clinical Oncologists, American Association for Cancer Research, Society of Gynecologic Oncologists, The International Gynecologic Cancer Society, the Society for Integrative Oncology, the National Consortium of Breast Centers and the International Society for Sexuality and Cancer. In 2006, he became Vice President for the National Consortium of Breast Centers and will continue as Program Chair for the 2009 Annual Meeting. He serves on the Education Committee and as a member of the Speakers’ Bureau for the International Gynecologic Cancer Society. 24
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Carolyn McCourt, MD BA: Creighton University Residency: Washington University (MO) Fellowship: Women & Infants Hospital of Rhode Island Dr. McCourt joined the faculty of the Program in Women’s Oncology as Assistant Professor in 2008. Dr. McCourt is board certified in Obstetrics and Gynecology. She has major research interest in clinical trials and serves as the Women & Infants’ site Co-Principal Investigator for the Gynecologic Oncology Group (GOG), a clinical and basic science research, non-profit organization supported by the National Cancer Institute. She is a member of several professional societies, including the Society of Gynecologic Oncology, American College of Surgeons, and American Society of Clinical Oncology. Richard Moore, MD, FACOG MD: University of Alberta Residency: Eastern Virginia School of Medicine Fellowship: Women & Infants Hospital of Rhode Island /Brown University Dr. Moore is an Associate Professor in the Department of Obstetrics and Gynecology. He is the director of the Center for Biomarkers and Emerging Technologies (CBET) and an associate director of the Program in Women’s Oncology. Dr. Moore is board certified in Obstetrics and Gynecology and Gynecologic Oncology. He is a Fellow of the American Board of Obstetrics and Gynecology and the American College of Surgeons. He is a member of the Society of Gynecologic Oncologists, the New England Association of Gynecologic Oncologists and the Society of Surgical Oncologists. Dr. Moore leads the basic science laboratory for the Program in Women’s Oncology. His Research interests include the development of novel biomarkers for ovarian and endometrial cancers. His research in ovarian cancer has led to the clinical development of a novel biomarker (HE4) now used in the management of ovarian cancer patients world wide. Dr. Moore was also instrumental in the development of the Risk of Ovarian Malignancy Algorithm (ROMA) used for risk assessment for the diagnosis of ovarian cancer in women with a pelvic mass. HE4 has recently been cleared by the US FDA for monitoring patients with ovarian cancer. Dr. Moore is also one of the pioneers for the use of sentinel lymph node technology in the treatment of patients with vulva cancer. Dr. Moore has authored over 30 peer reviewed papers and book chapters.
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MD: Creighton University
Bachir J. Sakr, MD
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MD: Lebanese University Residency: Detroit Medical Center Fellowship: University of Pittsburgh Dr. Sakr is a medical oncologist and joined the staff at the Program in Women’s Oncology in early 2007. Dr. Sakr practiced as a primary care provider and hematology/oncology specialist in Providence for a few years before joining the Program in Women’s Oncology. He was born in Lebanon and received his medical degree from The Lebanese University. He did clinical rotations in medicine and surgery in Lebanon, before coming to the United States for his internship and residency. He also completed a fellowship in hematology and oncology at the University of Pittsburgh Medical Center. Fluent in Arabic and French, Dr. Sakr is certified by the American Board of Internal Medicine in medical oncology and hematology. Trevor Tejada–Bergés, MD BS/MS: McGill University MD: McGill University Residency: Royal Victory Hospital, McGill University Fellowship: Women & Infants Hospital of Rhode Island Dr. Tejada–Bergés joined the Program in July 2001 as a Gynecologic Oncology fellow. He completed the Gynecologic Oncology fellowship, and then stayed on to continue a Breast Care Fellowship. He is now an Assistant Professor of Obstetrics and Gynecology for the Warren Alpert School of Medicine at Brown and cares for patients with both gynecologic malignancies and breast cancer. He is Board-certified in both Obstetrics and Gynecology and Gynecologic Oncology. His current clinical interests lie in the field of racial disparities in cancer care and palliative/end-of-life care. Given his involvement in the field, he was recently invited by the National Office of Minority Health to participate in the National Partnership for Action to Eliminate Health Disparities. In 2009 he received the APGO award for exceptional teaching by the medical students at Brown. He was also recently recognized by the American Cancer Society with the Sandra C. Labaree Volunteer Values Award. He is a candidate member of the Society of Gynecologic Oncologists (SGO), where he serves on the Breast Cancer Task Force, and the New England Association of Gynecologic Oncologists (NEAGO). He is a member of the American Society of Breast Surgeons (ASBS) and the American Society of Breast Disease (ASBD). Katina Robison, MD, completed her fellowship and joined the faculty at the Program in Women’s Oncology as Assistant Professor in July of 2009. She was chosen as a Women’s Reproductive Health Research Scholar in March of 2009. She completed her BA in Psychology at San Francisco State University in 1996, followed by her medical doctorate at the University of Pittsburgh in 2002. She completed her Obstetrics and Gynecology residency training and Gynecologic
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Oncology Fellowship at Women & Infants Hospital of Rhode Island in June 2009. As a WRHR scholar, she is actively involved in clinical research, including a study evaluating barriers to at the end of this year in a study determining the prevalence of HPV and genotype distribution among Southeast Asian women in Rhode Island. She also continues to be involved in Dr. Moore’s prospective sentinel lymph node study in patients with vulvar cancer and has recently completed a retrospective study evaluating the long-term use of Doxil in women with recurrent Ovarian Cancer. In addition, she is developing a survivorship database among women with Gynecologic Malignancies.
FELLOWSHIP TRAINING Sonali V. Pandya, MD, will complete her Breast Fellowship at Women & Infants Hospital in July 2010. Dr. Pandya completed medical school at Saint George’s University School of Medicine in Grenada, West Indies and graduated in 2004 with a Doctorate in Medicine. After graduating, she completed a four year residency in General Surgery at Albany Medical Center, Albany NY. Dr. Pandya was the recipient of the Intern of the Year Award in 2005. Nada Mufid Kawar, MD, is a second year Fellow in the Program in women’s Oncology. Dr. Kawar completed medical school at Washington University School of Medicine in St. Louis Missouri and graduated in 2005 with a Doctorate in Medicine. After graduating, she completed a four year residency in Obstetrics and Gynecology at the University of California, San Francisco. Dr. Kawar was administrative Chief Resident at University of California, San Francisco, from 2008 to 2009. Katrin Kristjansdottir, MD, is a third year Fellow in the Program in Women’s Oncology. Dr. Kristjansdottir completed medical school at the University of Iceland and graduated in 2001 with a Candidatus Medicinae degree. After graduating, she completed a one-year internship with the University Hospital of Iceland. She then worked as a house officer at the department of OB/Gyn at the University of Iceland Hospital for a year before completing her OB/Gyn residency at the University of Colorado HSC in 2007. After residency, Katrin worked for a year as an attending at Denver Health and Hospital and was part of the teaching faculty at the University of Colorado HSC during that time. Shannon MacLaughlan, MD, is the Senior Fellow in the Program in Women’s Oncology. Dr. MacLaughlan completed her BS degree in biology with a minor in religious studies at Stetson University in DeLand, Florida in 1998. She received her medical doctorate from the University of Florida College in Medicine in 2002, and completed her obstetrics and gynecology residency at Greenville Hospital Systems University Medical Center, Greenville, SC in 2006. After graduation she worked for a year in the Women & Infants’ Hospital triage unit before joining the Program in 2007. Dr. MacLaughlan is currently conducting a pilot study in collaboration with The Program in Women’s Oncology Integrative Care Program investigating the use of hypnotherapy and gabapentin for therapy-induced hot flashes in breast cancer survivors. (continued)
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cervical cancer screening among Southeast Asian women and enrollment will be completed
Ashley Stuckey, MD, completed her combined Gynecologic Oncology and Breast Surgery Fel-
Gynecologic Oncology
lowship in June 2010 and will be joining the Program in Women’s Oncology in July 2010. Dr. Stuckey received her B.A. in French from Davidson College in 1996. She received her medical doctorate in 2001 from Louisiana State University Health Sciences Center and then completed her Obstetrics and Gynecology residency training in June of 2005 at the same institution. She completed a Pelvic Surgery fellowship at Lahey Clinic in June of 2006. She was the first fellow to complete the new four-year program focusing on additional training in breast health.
NEW ARRIVALS TO THE DIVISION Beth Cronin, MD, will begin her Gynecologic Oncology Fellowship at WIH in July 2010. Dr. Cronin completed medical school at the University of Vermont College of Medicine in Burlington VT and graduated in 2006 with a Doctorate in Medicine. After graduating, she completed a four-year residency in Obstetrics and Gynecology at Women and Infants’/Brown University. Dr. Cronin was Administrative Chief Resident at Women and Infants’/Brown University, from 2009 to 2010. Dr. Cronin was the recipient of the Women and Infants Hospital Excellence in Teaching Awards from 2007 – 2010. She was the recipient of the Professionalism and Humanism in Women’s Health Award in 2009 and the David H. Nichols Award for Excellence in Pelvic Surgery in 2010. Marcia Humphrey Schmidt, MD, will begin her Breast Fellowship at Women & Infants Hospital in July 2010. Dr. Humphrey Schmidt completed medical school at Upstate Medical University, State University of New York and graduated in 2002 with a Doctorate in Medicine. After graduating, she completed a four-year residency in Obstetrics and Gynecology at Winthrop University Hospital, and went on to complete a one-year Fellowship in Pelvic Surgery at Emory University School of Medicine, followed by a three-year Gynecologic Oncology Fellowship at the University of South Florida.
THE MEDICAL STAFF — BREAST HEALTH CENTER Robert D. Legare, MD MD: Tufts Residency: Yale-New Haven Fellowship: Brigham and Women’s Dr. Legare is an Associate Professor of Obstetrics and Gynecology (Clinical) at Women & Infants Hospital of Rhode Island/Brown University. Dr. Legare was an Associate Physician at Brigham & Women’s Hospital and Dana-Farber Cancer Institute and an Instructor in Medicine at Harvard Medical School, 1996 – 1997. As a medical oncologist/hematologist he is an integral part of both the Gyn-Onc Clinic and the Breast Health Center. Dr. Legare is the Director of the Breast Health Center and Cancer Risk Assessment and Prevention Program in The Program in Women’s Oncology. He is board certified in Medical Oncology, Hematology and Internal Medicine. He is Instructor for small group sessions, Pathophysiology/Hematology (Bio350), 28
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Brown University School of Medicine. Dr. Legare has received the Dean’s Teaching Excellence Award from Women & Infants Hospital of Rhode Island/Brown University from 2000-2009. He is a University Oncology Group and the author of many papers, abstracts and chapters. Jennifer S. Gass, MD, FACS MD: University of Maryland Residency: Temple University Hospital Dr. Gass is Chief of Surgery at Women & Infants Hospital of Rhode Island, Director of the Breast Fellowship at the Breast Health Center, as well as Clinical Assistant Professor at the Warren Alpert Medical School of Brown University from 1993–present. She is Board Certified in general surgery. She is on the staff of Women & Infants Hospital of Rhode Island, Rhode Island Hospital, and Miriam Hospital. In 2002–2003 she attended in the Surgical Intensive Care Unit at Rhode Island Hospital. She is a member of the American Society of Breast Surgeons, Rhode Island Medical Women’s Association, Rhode Island Medical Society, American Medical Women’s Association, Association of Women Surgeons, American College of Surgeons, American Medical Association, Society of Surgical Oncology, and the New England Surgical Society. Under Dr. Gass’s supervision, the Women & Infants’ Breast Fellowship received 5 year certification by the Society of Surgical Oncology. She reviews for the annals of Surgical Oncology, The Journal of Surgical Oncology, The American Journal of Clinical Oncology, and The Journal of the American College of Surgeons. She is the program co-chair for the 2010 National Consortium of Breast Centers Annual Meeting. She serves on the ethics committee and the board of Advocates for the American Society of Breast Surgeons and the Breast Program Directors Chair committee for the Society of Surgical Oncology and the program for American Society of Clinical Oncologist Breast Meeting. At Women and Infants’ she serves on the CME committee, and the GYN Review group. At Brown, she serves on the Medical School Admissions Committee. Ekaterini Tsiapali, MD MD: National University of Athens Residency: East Tennessee State University Fellowship: Women & Infants Hospital of Rhode Island Dr. Tsiapali joined the Program in Women’s Oncology as a General and Breast surgeon in September 2007. She is a native of Greece, who started her General Surgery training in Greece (receiving her MD from the National University of Athens) and moved to the US when she was offered a position as a Research Fellow at East Tennessee State University. After a year of bench research on Trauma and Sepsis, she proceeded to complete a General Surgery Residency. She came to Women and Infants’ in 2006 for her fellowship. Her special interests include oncoplastic breast surgery and advanced laparoscopy.
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member of the American Society of Clinical Oncology, American Society of Hematology, Brown
Doreen L. Wiggins, MD, FACOG, FACS
Gynecologic Oncology
BA: University of Rhode Island MD: Brown Medical School Residency: Women & Infants Hospital of Rhode Island Fellowship: Women & Infants Hospital of Rhode Island Dr. Wiggins is part of the Breast Health Center team as a Breast Surgeon. She is an Assistant Clinical Professor of Obstetrics and Gynecology at Brown Medical School. She received a Teaching Excellence Award presented by Brown University Medical Students in 1990. She is a fellow of the American College of Obstetrics and Gynecology. In 2000, she completed training as a children’s grief counselor at the Dougy Center in Oregon. She has served as the Vice President of Friend’s Way and volunteered as a facilitator to help children. Dr. Wiggins received a Partner in Philanthropy Award in 2002 by the Rhode Island Association of Fundraising Professionals. She is a member of the American Medical Association, the Society of Surgical Oncology, the American Society of Breast Surgeons, the American Society of Breast Disease, the American College of Surgeons, the American Society of Clinical Oncology, and former member of the Board of Directors of Friend’s Way. Dr. Wiggins was chosen to be one of the 26 cyclists in the Tour of Hope, a transcontinental bicycling tour by Lance Armstrong to promote cancer research. Dr Wiggins continues her relationship with the Lance Armstrong Foundation as an advocate for cancer patients, and was selected to go to Washington, D.C. as part of “Livestrong Day” and meet with members of Congress in 2005 and 2006. She also represented the Lance Armstrong Foundation for the American Cancer Society “One Voice Against Cancer (OVAC) in Washington, DC in June 2008. In July 2006, as a team member she summitted Mt. Shasta (14, 162 ft) in California for the Breast Cancer Fund to raise awareness regarding the environmental causes of breast cancer. Dr. Wiggins is the Co-Director of the Center for Sexuality, Intimacy and Fertility through the Program in Women’s Oncology dedicated to helping cancer patients improve quality of life and provide a much needed resource. Dr. Wiggins coordinates resident teaching in breast service at Brown Medical School and has received excellence in teaching awards, 2004 through 2008. She was also a course leader for postgraduate course “Breast Cancer and GYN Patient” at the Annual Clinical Meeting of ACOG in May 2008. Dr. Wiggins resigned from her position in December 2009 to pursue other opportunities. David A. Edmonson, MD, FACS, joined the staff of the Breast Health Center in June of 2010. Dr. Edmonson received his B.S. in Biology from Vanderbilt University in Nashville, TN in 1993. He received his medical degree in 1999 from St. Georges University School of Medicine. He completed his general surgery internship and residency at Albany Medical Center in Albany, NY, and was Chief Resident in 2004. Dr. Edmonson completed his Fellowship in Surgical Oncology of the Breast in 2005 at Women and Infants’ Hospital. He is board certified in general surgery. Dr. Edmonson is also a Fellow of the American College of Surgeons and is a member of numerous professional societies including the American Society of Breast Surgeons. Dr. Edmonson had been in private practice in Albany NY prior to returning to Providence. He returns to pursue further interests in teaching and research. His interests include genetically-based breast cancers and the prevention and treatment of lymphedema. 30
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Steven I. Cohen, MD, FACS, joined the staff of the Breast Health Center in 1995. Dr. Cohen is a Clinical Assistant Professor in the Department of Surgery at Brown University. He received certified in general surgery. Dr. Cohen is a fellow of the American College of Surgeons and a member of numerous professional societies. Arnold H. Herman, MD, FACS, joined the staff of the Breast Health Center in 1995. Dr. Herman is a Clinical Associate Professor in the Department of Surgery at Brown University. He received his medical degree in 1966 from the University of Kansas and completed his surgical residency at Boston University. Dr. Herman is board certified in general surgery. He is a fellow of the American College of Surgeons and a member of numerous professional societies including the American Society of Breast Surgeons. He is a surveyor for the Commission on Cancer of the American College of Surgeons. R. James Koness, MD, joined the staff of the Breast Health Center in June 2004. Dr. Koness received his B.S. in Biology from Boston College in Chestnut Hill, Massachusetts in 1978 and his MD from SUNY–Buffalo School of Medicine, Buffalo, New York in 1983. He completed his internship and residency in general surgery at Brown University in 1988 and completed his fellowship in surgical oncology at Roger Williams Medical Center in 1990. He was an Instructor in Surgery at Brown University from 1987–1991 and is currently a Clinical Assistant Professor in the Division of Surgical Oncology, Department of Surgery, Brown University. Dr. Koness is a fellow of the American College of Surgeons and is a member of the Rhode Island Chapter of the American College of Surgeons, New England Surgical Society, Society of Surgical Oncology, American Society of Head and Neck Surgeons, and American Society of Breast Surgeons. Gabriela B. Masko, MD, joined the staff of the Breast Health Center in June 2003. She is currently Clinical Assistant Professor of Radiation Medicine at Brown University, Division of Biology and Medicine and Clinical Instructor of Radiation Oncology at Tufts University School of Medicine. She received her B.A. in 1980 from Yale University and her medical degree in 1984 from Tufts University School of Medicine. Dr. Masko is board certified in Radiation Oncology and a member of several professional societies. Kathy Radie-Keane, MD, joined the staff of the Breast Health Center in December 2005. She is currently Clinical Assistant Professor in Radiation Medicine at Brown University, Division of Biology and Medicine. She received her B.S., at Emmanuel College, 1980 Boston, MA and her medical degree in 1986 at Tufts University School of Medicine. Dr. Radie-Keane is board certified in Radiation Oncology and a member of several professional societies. William M. Sikov, MD, joined the staff of the Breast Health Center in July 2003. He is principal investigator, CALGB, Rhode Island Hospital and Clinical Assistant Professor of Medicine at Brown University School of Medicine. Dr. Sikov received his A.B. in Russian Studies in 1978 from Brown University and his medical degree in 1982 from Yale University School of Medi(continued)
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his medical degree in 1968 from Downstate Medical Center, Brooklyn, New York. He is board
cine. He completed an internship and residency in Internal Medicine at the University Health
Gynecologic Oncology
Center, Pittsburgh, PA, in 1985 and a fellowship in Hematology–Oncology at the New England Medical Center, Boston, MA, in 1989. Dr. Sikov is board certified in Internal Medicine, Hematology, and Medical Oncology. He is a member of numerous professional societies and has major research interests in the treatment of breast cancer. He chairs the Brown University Oncology Group (BRUOG) Breast Cancer Committee. Rochelle Strenger, MD, is a Clinical Assistant Professor of Medicine at Brown University School of Medicine and a Medical Oncologist at the Breast Health Center for over 10 years. She received her BA in Biology from Barnard College in 1972 and MS from Columbia University in 1978. She received her MD degree from Albert Einstein College of Medicine in 1982 and completed her Internal Medicine residency at Brigham and Women’s Hospital in Boston in 1985. She then completed a Research/Clinical fellowship in the Division of Hematology/Oncology at the same hospital. Dr. Strenger is board certified in Medical Oncology and Internal Medicine. She is a member of numerous societies. Dr. Strenger was the 2009 recipient of the first Adele R. Decof Rose award for excellence in patient centered care. She was the recipient of the American Medical Women’s Association Service Award in 1999 and was named RI Women Physician of the year in 2001. Her major interests are in Women’s Health and Breast Oncology. Charu Taneja, MD, joined the staff of the Breast Health Center in June 2004. She received her M.B., B.S. from Maulana Azad Medical College, University of Delhi, New Delhi, India in 1989. Dr. Taneja completed her residency in Surgery at L.N.J.P.N. Hospital, Maulana Azad Medical College, University of Delhi in 1993, and her residency in Surgery at the University of Medicine and Dentistry, New Jersey Medical School in 1999. Dr. Taneja completed her fellowship in Surgical Oncology at Boston University – Roger Williams Medical Center in 2001. She is currently Clinical Assistant Professor in the Department of Surgery, Boston University Medical Center, Boston, Massachusetts and Director of the Breast Health Program at Roger Williams Medical Center. Dr. Taneja is board certified by the American Board of Surgery. She is a member of the American College of Surgeons, Society of Surgical Oncology, Association of Women Surgeons, American Society of Clinical Oncology and Southeastern Surgical Congress. David E. Wazer, MD, joined the staff of the Breast Health Center in June 2003. He is currently Joint Professor and Chairman at Tufts University School of Medicine and Brown Medical School; Radiation Oncologist–in–Chief at Tufts Medical Center, Rhode Island Hospital, and Women & Infants Hospital of Rhode Island; and Chief of Radiation Oncology Services, Lifespan Healthcare System. Dr. Wazer received his A.B. (Honors) in 1978 from Holy Cross College in Worcester, Massachusetts, his Doctor of Medicine degree (Honors) in 1982 from New York University School of Medicine, New York, New York, and his Master of Arts honorary degree in 1999 from Brown University. Dr. Wazer completed his internship in Medicine in 1983 at Roger Williams General Hospital, his research fellowship in the Department of Psychiatry Laboratory of Dr. John Rotrosen, New York University School of Medicine in 1984, his residency in Radiation Oncology in 1988 at New England Medical Center/Tufts University, and was chief resident in Radiation Oncology from 1987–1988 at New England Medical Center/Tufts University. He is a member of numerous societies and has major research interests. 32
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2009 issue of Women and Cancer Magazine (Womenandcancermag.com). The article was titled Lymphedema and Gynecologic Cancers. Courtney Dieterich, OSW-C, received her Oncology Social Work certification. Dr. Granai was the keynote speaker at the First Annual Ovarian Cancer Research Fund’s Super Luncheon, hosted by First Lady Suzanne Carcieri, at the University Club, Providence RI, on September 9, 2009. On October 30, 2009, the Breast Health Center held a BHC Fair “Inside the Breast Health Center, a Place for Health, Wellness and Healing.” Speakers included Dr. Gass, who gave a presentation titled “New Surgical Options, Including Nipple Sparing Mastectomy and Oncoplastics”; Dr. Legare, who gave a presentation titled “A Unique Approach to Care”; Dr. Pandya, whose talk was titled “A Fellow’s Perspective on Care, High-Risk, and Screening; and Lauren Solomon, RD, LDN, who gave a presentation titled “Nutrition for Breast Health.” Social Work participated, and Integrative Care Therapies, Promotional Items, and other information on the Breast Health Center were provided. Dr. Gass was an invited guest speaker at the Festival Ballet “Legacy of Loss”. She gave a presentation titled “A New Legacy of Knowledge, Choice and Beauty” on October 18th at the Festival Ballet, Providence RI. November 13 – 14, 2009, Dr. Granai and Dr. Moore presented at the 3rd Asia Pacific Congress: Controversies in Obstetrics, Gynecology, & Infertility, Shangri-La’s Kerry Centre Hotel, Beijing, China. The conference was attended by over 500 international physicians, healthcare leaders, and administrators. Dr. Granai participated in the following:
• Invited Speaker: Pelvic mass in pregnancy: When Do We Need to Intervene? • Dr. Granai served as Chairperson and as a discussant on the following topic: Hot Controversies – Expert Opinion on: Cervical Cancer and Human Papilloma Virus (HPV): Does Vaccination Mark the End of Cervical Cancer?
• Dr. Granai was the Keynote Speaker for “VOICES” – Special Entertainment Lecture. Dr. Moore participated in the following:
• Chairperson – Women and Ovarian Cancer: From Conception to Diagnosis “Early Diagnosis of Ovarian Cancer Can Improve Prognosis
• Dr. Moore served as a discussant on the following topic: Hot Controversies – Expert Opinion on: Cervical Cancer and Human Papilloma Virus (HPV): Does Vaccination Mark the End of Cervical Cancer? January 12, 2009, Dr. Legare was listed in RI Monthly as one of the Top Docs for Medical Oncology. (continued)
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Dr. McCourt had a featured article for the Gynecologic Oncology Group section of the Summer
Dr. Granai was selected as one of America’s Top Doctors for Cancer by Castle Connelly, the na-
Gynecologic Oncology
tion’s leading source of identifying top doctors for 2009. Dr. Granai was accepted as a Fellowship Candidate by the American Gynecological and Obstetrical Society (AGOS). Dr. Brard was appointed as a committee member in Experimental Medicine, Gynecologic Oncology Group – January 2010 Dr. Paul Disilvestro was named Co-Chairman of the Ovarian Cancer Committee for the Gynecologic Oncology Group (GOG). Dr. Granai was voted “Best Doctor in Rhode Island” (Gynecologic Oncology) by Rhode Island Monthly Magazine, May 2010 On June 29, 2010, Dr. Gass attended the RI American Cancer Society Annual Membership Meeting where she will be inducted as the New Secretary Treasurer for the RI American Cancer Society.
GRANTS Cain, JM K12 HD050108-06 10/1/08 – 3/31/15 (Principal Investigator) $2,200,000 Grant total Women’s Reproductive Health Research Career Development Award 1R01CA136491-01A1 Brard L (PI) 6/1/2009- 4/30/2014 NCI/NIH $ 2,753,225 (TC) Development of an Assay for the Early Detection of Ovarian Cancer. Ovarian cancer is on of the most lethal cancers affecting women. This is due to the inability to detect it while still localized to the ovaries. Early detection would result in a 90% survival rate. LPA, a currently controversial biomarker for ovarian cancer diagnosis, is the subject of this application. A simple new method for detecting LPA and a fresh approach to validating LPA’s reliability as an accurate biomarker would emanate from the proposed studies. Role: PI The Integrative Care Program had a prestigious visit from the RI Foundation, which is now considering awarding the program a $75,000 grant. Funds would be utilized in part to broaden outreach and expand education about the potential benefits of integrating complementary approaches into the cancer care continuum.
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The major goals of this project are to understand the genetic and phenotypic differences between primary and metastatic ovarian cancer growths that may affect therapeutic response. We expect to genotype each tumor and match the genetic differences to drug response phenotypes including probing cisplatin sensitivity relative to the regulation of drug efflux systems. Role: Significant Contributor (Brard L) RI Research Alliance 2010 Collaborative Research Grants Brard L (PI) Submitted October 2009 Genetics of Primary and Metastatic Ovarian Cancer: Towards Personalized Therapies NCI/NIH R21CA143667-01A1 Brard L (PI) Submitted November 2009 Cranberry Extracts for the Treatment of Ovarian Cancer. 2010- A Phase II Trial of Belinostat and Carboplatin in Platinum-Resistant Ovarian Cancer (GOG 126-T). Gynecologic Oncology Group, NCI Grant/Contract U10-CA27469. 2010- A Phase I Trial of Intraperitoneal Bortezomib and Carboplatin in Recurrent Ovarian Cancer (GOG 9924). Gynecologic Oncology Group, NCI Grant/Contract U10-CA27469. 2010- National cancer Institute, Grant R21CA137290-01A2. Social Networks and Care Planning in Women with Cancer. Amount: $250,000. PI: Melissa A. Clark; Co-PI: Don S. Dizon.
ORIGINAL PUBLICATIONS IN PEER-REVIEWED JOURNALS Sakr B J, Dizon D S, Legare R, Gamage M, Wood R, Colvin G A, Constantinou M, Kennedy T A, Fenton M, Sikov W M; Women and Infants Hospital, Providence, RI; Alpert Medical School of Brown University. Frequent pathologic complete responses in aggressive stages II to III Breast Cancers with every-4-week Carboplatin and weekly Paclitaxel with or without Trastuzumab: A Brown University Oncology Group Study. J Clin Oncol, 2009 Oct 1;27(28):693-700. Rizack T, Mega A, Legare R, Castillo J. Management of hematological malignancies during pregnancy. Am J Hematol. 2009 Sept 16;84(12):830-841. Robison K, MD. Guidance for Cervical Cancer Prevention and Control: LEEP/Cervical Cone. International Federation of Gynecology & Obstetrics. October 2009 Clements A, Robison K, Granai C O, Margaret M M, Wilbur-Scalia J, and Moore R G. A Case of Peutz Jeghers Syndrome with Breast Cancer, Bilateral Sex Cord Tumor with Annular Tubules and Adenoma Malignum caused by STK11 Gene Mutation. International Journal of Gynecologic Oncology . Dec 2009; 19 (9): 1591-4 McCourt C, Dessi S, Bradley A M, Schwartz J, Brard L, Dizon D S. Is there a taxane-free interval that predicts response to taxanes as a later-line treatment of recurrent ovarian or primary peritoneal cancer? Int J Gynecol Cancer, 2009; 19: 343-7. (continued)
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5P41RR001395 - Supplemental Smith P (PI) 10/01/09 - 09/30/11 NIH/NCRR BioCurrents Research Center - Mechanisms of Cisplatin Resistance in Ovarian Cancer
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Gray D L, Dicke J M, Dickerson R, McCourt C, Obibo A O. “Reevaluating humeral length for the detection of fetal trisomy 21.” J Ultrasound Medicine, 2009; 28:1325-30. Hensley M, Sill M, Scribner D, Brown J, DeBernardo R, Hartenbach E, McCourt C K, Bosscher J, Gehrig P. “Sunitinib Malate in the treatment of recurrent or persistent uterine leiomyosarcoma: A Gynecologic Oncology Group phase II study.” Gynecol Oncol, 2009; 115:460-5. Moore R G, McMeekin S D, Brown A K, DiSilvestro P A, Miller C M, Allard J W, Gajewski W, Kurman R J, Bast R C, Skates S J.: “A Novel Multiple Marker Bioassay Utilizing HE4 and CA125 for the Prediction of Ovarian Cancer in Patients with a Pelvic Mass.” Gynecologic Oncology, 112(1): 40-6, 2009. Mathews C, Restivo A, Raker C, Weitzen S, DiSilvestro P A: “Willingness of Gynecologic Cancer Patients to Participate in Clinical Trials.” Gynecologic Oncology, 112(1): 161-5, 2009. Walker J L, Morrison A, DiSilvestro P A, VonGruenigen V E: “A phase I/II study of extended field radiation therapy with concomitant paclitaxel and cisplatin chemotherapy in patients with cervical carcinoma metastatic to the para-aortic lymph nodes: A gynecologic oncology group study.” Gynecologic Oncology, 112 (1): 78-84, 2009. Rardin C R, Moore R G, Ward R M, Myers D L. Recurrent thigh abscess with necrotizing fasciitis from a retained transobturator sling segment. Journal of Minimally Invasive Gynecology, 2009, 16(1), 84-87 Kuroki L, Stuckey A, Hirway P, Raker C, Bandera C, DiSilvestro P A, Granai C O, Legare R D, Sakr B, Dizon D S. “Addressing clinical trials: Can the Multidisciplinary Tumor Board improve participation? A study from an academic women’s cancer program”. Article In Press. G ynecol Oncol 2009 Allard J W and Moore R G. The novel biomarker HE4 improves the sensitivity of CA125 alone for monitoring and differential diagnosis of ovarian cancer. Clinical Laboratories International, 2009, 3, 20-21 Erekson E A, Sung V W, DiSilvestro P A, Myers D L: “Urinary Symptoms and impact on quality of life in women following treatment for endometrial cancer.” International Urogynecology Journal, 20(2): 159-63, 2009. Shah N, Dizon D S. New generation platinum agents for solid tumors. Future Medicine 2009; 5:33-42. Schwartz J, Toste B, Dizon D S. Chemotherapy toxicity in gynecologic cancer patients with a body surface area (BSA) > 2m(2). Gynecol Oncol 2009; 114:53-6. Dizon D S, Blessing J A, McMeekin D S, Sharma S K, DiSilvestro P A, and Alvarez R D. Ixabepilone as a second-line treatment in advanced endometrial cancer: Phase II Results of Gynecologic Oncology Group Trial 129-P. J Clin Oncol 2009; 27:3104-08. Dizon D S. Quality of life after breast cancer: survivorship and sexuality. The Breast Journal. 2009; 15:500-4. Dizon D S, Perez K, DiSilvestro P A, Taneja C, Ilson D. Stage IV small bowel carcinoma mimicking advanced ovarian cancer: case report and review of the literature. American Surgeon 2009; 75:864-5. Sikov W M, Dizon D S, Strenger R, Legare R D, Theall K P, Graves T A, Gass J S, Kennedy T A, and Fenton M A. Frequent pathologic complete responses in aggressive stage II-III breast cancers with q4week carboplatin and weekly paclitaxel + trastuzumab: a Brown University Oncology Group study. J Clin Oncology 2009; 27:4693-700. 36
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Bandera C A and Magrina J F. Robotic surgery in gynecologic oncology. Curr Opin Obstet and Gynecol 2009,21: 25-30. Stuckey A, Dizon D S, Scalia Wilbur J, Kent J, Tejada-Berges T, Gass J, Legare R.; Clinical characteristics and choices regarding risk-reducing surgery in BRCA mutation carriers.“ Gynecol Obstet Invest. 2010 Jan 21;69(4):270-273 [Epub ahead of print] Tung N, Wang Y, Collins L C, Kaplan J, Li H, Gelman R, Comander A H, Gallagher B, Fetten K, Krag K, Stoeckert K A, Legare R D, Sgroi D, Ryan P D, Garber J E, Schnitt S J. Estrogen receptor positive breast cancers in BRCA1 mutation carriers: clinical risk factors and pathologic features.; Breast Cancer Res. 2010 Feb 11;12(1):R12; Breast Cancer Res. 2010 Feb 11;12(1):R12. Krotz S P, Robins J C, Ferruccio T M, Moore R G, Steinhoff M M, Morgan J R, Carson S. In vitro maturation of oocytes via the pre-fabricated self-assembled artificial human ovary. Journal of Assisted Reproductive Genetics, Published online: 8/25/2010 DOI 10.1007/s10815-010-9468-6 Kuroki L, Stuckey A, Hirway P, Raker C A, Bandera C, DiSilvestro P A, Granai C O, Legare R D, Sakr B J,Dizon D S. Addressing clinical trials: can the multidisciplinary tumor board improve participation? A study from an academic women’s cancers program. Gynecologic Oncology. 2010; 116:295-300. Penson R, Dizon D S, Cannistra S, Roche M, Krasner C, Berlin S, Horowitz N, DiSilvestro P A, Matuonis U, Lee H, King M, Campos S: “Phase II Study of Carboplatin, Paclitaxal, and Bevacizumab with Maintenance Bevacizumab as First-Line Chemotherapy for Advanced Mullerian Tumors.” Journal of Clinical Oncology, 28(1): 154-59, 2010. Fleming G, Sill M, Darcy K, McMeeking D, Thigpen J, Adler L, Berek J, Chapman J, DiSilvestro P A, Horowitz I, Fiorica J: “Phase II Trial of Trastuzumab in Women with Advanced or Recurrent, HER2-Positive Endometrial Carcinoma: A Gynecologic Oncology Group Study.” Gynecologic Oncology, 116(1): 15-20, 2010. Moore R G, MacLaughlan S, Bast R C. Current state of biomarker development for clinical application in epithelial ovarian cancer. Gynecologic Oncology, 2010, 116, 240-245 Moore R G, MacLaughlan S. Clinical use of Biomarkers for Epithelial Ovarian Cancer. Current Opinion in Oncology, 2010, 22, 492-497 Moore R G, Jabre-Raughley M, Brown A K, Robison K M, Miller M C, Allard W J, Kurman R J, Bast R C, Skates S J. Comparison of a Novel Multiple Marker Assay Versus the Risk of Malignancy Index for the Prediction of Epithelial Ovarian Cancer in Patients with a Pelvic Mass. The American Journal of Obstetrics and Gynecology, 203, 3, 228.e1 – 228.e6doi: 10.1016/j.ajog.2010.03.043 Makhija S, Amler L C, Glenn D, Ueland F, Gold M, Dizon D S, Paton V, Birkner M, Lin C Y, Januario T, Ng K, Strauss A, Slikowski M, U Matulonis. Clinical Activity of Gemcitabine Plus Pertuzumab in Platinum-Resistant Ovarian Cancer, Fallopian Tube, or Primary Peritoneal Cancer: Low MRNA expression of the HER2-Coreceptor HER3 May be Predictive of Pertuzumab Activity. J Clin Oncol 2010; 28:1215-23. Stuckey A, Dizon D S, Legare R D, Scalia-Wilbur J, Kent J, Tejada-Berges T, Gass J. Clinical characteristics and choices regarding prophylactic surgery in BRCA mutation carriers. Gynecologic and Obstetric Investigation. 2010; 69:270-73.
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Dizon D S, Schutzer M E, Politi M, Linkletter C, Miller S, Clark M A. Advance Care Planning Decisions of Women with Cancer: Provider Recognition and Stability of Choices. J Psychosocial Oncology 2009; 27:383-95.
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Stuckey A, Dizon D S, Scalia-Wilbur J, Kent J, Tejada-Berges T, Gass J, Legare R et al. Clinical Characteristics and Choices regarding Risk-reducing Sugery in BRCA Mutation Carriers. Gynecologic and Obstetric Investigation. 2010;69:270-273.
BOOKS AND BOOK CHAPTERS Cain JM. Principles of Patient Care. Novak’s Gynecology, 15th Edition Berek, J (ed) Lippincott Williams & Wilkins, 2010. Dizon D S and Krychman M. Sexuality. In: Principles & Practice of Cancer Rehabilitation. M Stubblefield, M O’Dell, C Custodio, and T Fitzpatrick, Eds. New York: Demos. 2009. Krychman M A, Dizon D S, Amsterdam A, Partridge A. Cancer and Dyspareunia. In: Female Sexual Pain Disorders: Evaluation and Management. Goldstein, Pukall, and Goldstein, Eds. Towson:Blackwell. In Press, 2009. Stuckey A, Dizon D S. Choosing Treatments for Recurrent Ovarian Cancer: The Platinum-Free Interval. In Textbook of Gynaecological Oncology. Eds: A Ayhan, M Gultekin, P Dursun. Turkey: Gunes Publishing, 2009. Dizon D S, Tejada-Bergés T, Steinhoff M M, Sung C J, Koelliker S, Khalil H I, O’Conner B, MacAusland S, Taneja C, Legare R D, and Gass J S. Breast Cancer. In: Principles and Practice of Gynecologic Oncology, 5th Edition pp.897-946 RR Barakat, M Markman, ME Randall, EDS.Baltimore: Lippincott, Williams & Wilkins 2009. Stuckey A, Dizon D S. Choosing treatments for recurrent ovarian cancer: the platinum-free interval. The European Society of Gynecologic Oncologists’ Handbook for Fellows in Gynecologic Oncology. M. Gultekin, Ed. 2009. Questions and Answers About Human Papilloma Virus. Krychman M A, Dizon D S. Sudbury M A: Jones and Bartlett, 2010. DxRx Gynecologic Cancers. Campos S M, Dizon D S, Sudbury M A: Jones and Bartlett, 2010. Questions and Answers About Uterine Cancer. Duska L R, Dizon D S, Sudbury M A: Jones and Bartlett, 2010. DxRx Cervical Cancer: An approach to preinvasive and invasive malignancies of the cervix. Second Edition. Robison K, Dizon D S, Sudbury M A: Jones and Bartlett, 2010.
OTHER PEER-REVIEWED PUBLICATIONS Bowling, K, Cain JM. Clinical Educators: How can we meet the expanding need. Women’s Healthcare, Training the Next Generation of Women’s Healthcare Physicians. Changing Landscape in Academic Obstetrics and Gynecology. William F. Rayburn/Jay Schulkin (eds) Springer, 2010. Cain JM, Dickens et al. Bioethics Curriculum in Women’s Reproductive and Sexual Rights. International Federation of Gynecology and Obstetrics (FIGO), London UK, 2010. Lange T S, Stuckey A, Robison K, Kim K K, Singh R K, Raker C A, Bard L. “Effect of a Vitamin D3 derivative (B3CD) with postulated anti-cancer activity in an ovarian cancer animal model”. Invest New Drugs. 2009 Jul 7. Singh R, Lange T S, Kim K K, Brard L. “A coumarin derivative (RKS262) inhibits cell-cycle progression, causes pro-apoptotic signaling and cytotoxicity in ovarian cancer cells”. Invest New Drugs. 2009 Oct 29. [Epub ahead of print]. Kunz M A, Dizon D S. “Sexuality and intimacy following cancer”. US Obstetrics & Gynecology 2009; 3:21-23. 38
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Perez K, Gadgil M, Dizon D S. “Sexual ramifications of medical illness”. Clinics of Obstetrics and Gynecology 2009; 52:691-701. Lange T S, McCourt C, Singh R K, Kim K K, Singh A P, Luisi B S, Alpturk O, Strongin R, Brard L. “Apoptotic and chemotherapeutic properties of Iron(III)-salophene in an ovarian cancer animal model”. Drug Design, Development and Therapy:3 17-26 (2009). Saulnier Sholler G L, Brard L, Straub J A, Dorf L, Illyene S, Kalkunte S, Bosenberg M, Ashikaga N, Nishi R. “Nifurtimox Induces Apoptosis of Neuroblastoma Cells in Vitro and in Vivo”. J Pediatr Hematol Oncol. 31(3):187-193 (2009). Kawar N, Dizon D S. “Ixabepilone as a second-line treatment in advanced endometrial cancer”. Asian-Pacific Journal of Hematology and Oncology 2010. Epub online 2/2010. Moore R G, MacLaughlan S D, Bast R C Jr. “Current state of biomarker development for clinical application in epithelial ovarian cancer”. Gynecol Oncol. 2010 Feb;116(2):240-5. Lange T S, Zou Y, Singh R, Kim K, Kristjansdottir K, Saulnier-Sholler G L, Brard L. “Chemotherapeutic Effect of Calcidiol Derivative B3CD in a Neuroblastoma Xenograft Model”. In Press Chemical Biology & Drug Design, (April 2010). Kim K, Lange T S, Singh R, Brard L. “Lipophilic aroylhydrazone chelator HNTMB and its multiple effects in ovarian cancer cells”. BMC Cancer 10:72 (2010). Kristjansdottir K, Dizon D S. “HER-Dimerization Inhibitors: Evaluating pertuzumab in women’s cancers”. Expert Opinion on Biologic Therapy. 2010; 10:243-50. Dizon D S. “Treatment options for advanced endometrial cancer”. Gynecologic Oncology 2010; 117:373-81.
OTHER NON-PEER REVIEWED PUBLICATIONS Dwork A J, Christensen J R, Larsen K B, Scalia J, Underwood M D, Arango V, Pakkenberg B, Lisanby S H. “Unaltered neuronal and glial counts in animal models of magnetic seizure therapy and electroconvulsive therapy”, Neuroscience. 2009 Dec 29; 164(4):1557-64. Epub 2009 Sep 25. Moore R G, MacLaughlan S D. “A novel approach for the risk assessment of a pelvic mass for ovarian cancer”. The Female Patient, September 2009. Hachey K Dizon D S. “Personalizing chemotherapy through genetic profiling: will pharmacogenomics help improve and extend life for cancer patients?” Personalized Medicine, 2009; 6:481-4. Robison K, Dizon D S. “Cervical Cancer RX and DX”. Glasko-Smith-Klein. 2nd edition 2010
SCHOLARLY WORK IN OTHER MEDIA Dr. Sakr participated in an interview with Channel 10 on the need for patients to enroll in cancer research studies on August 3, 2009, Breast Health Center/ Women & Infants Hospital, Providence, Rhode Island. Dr. McCourt had a featured article for the Gynecologic Oncology Group section of the Summer 2009 issue of Women and Cancer Magazine (Womenandcancermag.com). The article was titled Lymphedema and Gynecologic Cancers. (continued)
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Dizon D S and Gass J S. “Perspective: Help or harm: Adjuvant therapies for primary invasive disease and the risk of a second contralateral breast cancer”. Am Journal of Hemat and Oncol 2009; Available at: http://www.ajho.com/Help-or-harm-Adjuvant-therapies-for-primary-invasivedisease-and-the-risk-of-asecond-contralateral-breast-cancer/article/141443/.
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Dr. Legare participated in an interview with Channel 10 to discuss the “Hereditary Breast and Ovarian Cancer: BRCA Testing and Beyond” Symposium; September 24, 2009. Dr. Sakr participated in an interview with Channel 6, discussing the new guideline and Recommendation around breast cancer screening on November 7, 2009, Breast Health Center/ Women & Infants Hospital, Providence, Rhode Island. Dr. Legare was interviewed by the Jewish Voice & Herald for a story on the breast cancer screening controversy – November 19, 2009 Dr. Legare gave a mammography position statement to Brown University, WIH, and Pharmawire – December 2009. Dr. Sakr interviewed at Channel 10 studios “Special Assignment” on January 7, 2010, discussion about new mammogram, screening guidelines, Cranston, Rhode Island. Dr. Legare participated in an interview on breast cancer for HEALTH magazine, a national publication – January 29, 2010 Dr. Moore participated in a video education taping for The Institute for Continuing Healthcare Education Regarding Ovarian Cancer Screening and Management to Improve Patient Survival, Houston TX – February 5, 2010. Dr. Legare had a commentary in the March issue of the Brown Medicine Magazine entitled “Check Yourself – What to do About Cancer Screening” – March, 2010
ABSTRACTS LOCAL/REGIONAL Cronin B, Robison K, Moore R, Dizon D S. Long-term use of Pegylated Liposomal Doxorubicin in recurrent ovarian carcinoma. Oral Presentation at New England Association of Gynecologic Oncologist Annual Conference, Cape Cod 2009. Fischer A, Kristjansdottir K, MacLaughlan S, Brard L, Brodsky A. Identifying metastatic microRNAs in ovarian cancer. Ovarian Cancer Research Symposium at Brown University. February 5, 2010. Malit B, MacLaughlan S, Dizon D S. Cancer patients and complementary and alternative medicine: barriers to enrollment in clinical trials. New England Association of Gynecologic Oncologists (NEAGO) Annual Meeting, June 12, 2010, Boothbay Harbor, ME. Roque D, MacLaughlan S, Tejada-Berges T. Patient death after a core needle biopsy of the breast: a case report. New England Association of Gynecologic Oncologists (NEAGO) Annual Meeting, June 12, 2010, Boothbay Harbor, ME. Pandya S V, Dizon D S, Gass J S, Hansen K, Raker C “ Management of Intraductal Papiloma – a clinical dilemma”. New England of Gynecologist Oncology Annual Meeting; June 11, 2010, Boothbay Harbor, ME.(Oral Presentation) Wu L, Robison K, Eng W, Douangsavanh A, Tejada-Berges T, Clark L, Raker C, S Pinto Granai C O, Dizon D S. Cervical Cancer Prevention: Participation and knowledge among Asian American women. Oral presentation at the New England Association of Gynecologic Oncologist Annual Conference, BoothBay Harbor, ME, June 2010 Holman L L, Robison K, Lopes V V, Noto R, Steinhoff M, Moore R. A comparison of sentinel 40
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Kawar N M, Kilfoyl K, Raker C, Lomme M, Dizon D S. Class III Beta-Tubulin Expression in Endometrial Carcinoma. Oral presentation of the 30th Annual Meeting of the New England Association of Gynecologic Oncologists (NEAGO). June 11-13, 2010, Boothbay Harbor, ME. Kawar N M, Tsai K, Dizoglio J, Dizon D S, Tsiapali E S. Reconstruction Trends Among Patients Undergoing Mastectomy for Breast Cancer Treatment or Prophylaxis. Oral presentation of the 30th Annual Meeting of the New England Association of Gynecologic Oncologists (NEAGO). June 11-13, 2010, Boothbay Harbor, ME. Wu L, Robison K M, Eng W, Douangsavanh A, Tejada-Berges T, Clark L, Raker C, Pinto S, Granai C O, Dizon D S. Cervical cancer prevention: participation and knowledge among Asian-American women. New England Association of Gynecologic Oncologist (NEAGO) Annual Meeting, June 13, 2010, Boothbay Harbor, ME. Hollman L L, Robison K M, Lopes V V, Steinhoff M, Moore R G. A comparison of sentinel lymph node identification between lymphoscintigraphy and sentinel lymph node dissection in patients with vulvar cancer. New England Association of Gynecologic Oncologists annual meeting, Booth Bay Harbor, Maine, June 11-13, 2010 Jackson A L, Miller C, Bast R C, Lambert-Messerlian G, Moore R G. Descriptive analysis of HE4 in healthy women, pregnancy and women with benign gynecologic disorders. New England Association of Gynecologic Oncologists annual meeting, Booth Bay Harbor, Maine, June 11-13, 2010 Jackson A L, Miller C, Eklund E, Lambert-Messerlian G, Moore R G. A novel biomarker for the management of patients with epithelial ovarian cancer. New England Association of Gynecologic Oncologists annual meeting, Booth Bay Harbor, Maine, June 11-13, 2010 Kawar N W, Tsai K, Dizoglio J, Dizon D S, Tsiapali E V. Reconstruction Trends Among Patients Undergoing Mastectomy for Breast Cancer Treatment of Prophylaxis….30 th Annual Meeting NEAGO conference in Booth Bay Harbor, ME…June 2010
NATIONAL Sakr B J, Dizon D S, Legare R D, Gamage M, Wood R, Colvin G A, Constatinou M, Kennedy T A, Fenton M, Sikov W M. Adjuvant therapy after neoadjuvant: Addressing the needs of a highrisk group. 2009 Breast Cancer Symposium. San Francisco, CA abstr 358. October 7-10, 2009. Sikov W M. Adjuvant therapy after neaodjuvant treatment: Addressing the needs of a high-risk group. 2009 Breast Cancer Symposium. San Francisco, CA; abstr 358. October 7-10, 2009. Wu L, Dizon D S, Santiago E, Hirway P, Koness R J, Gass J S, Taneja C. The incidence of abnormal pathologic findings in women undergoing elective breast reduction. 2009 Breast Cancer Symposium. San Francisco, CA; abstr 12. October 7-10, 2009. Singh A P, Singh R K, Kim K K, Shah S, Brard L, Vorsa N. LC-MS-MS quantification of cyclophosphamide SMSKCNR cells in absence and presence of cranberry proanthocyanidins. Eastern Analytical Symposium, November 16-19, 2009, Somerset NJ. Kent J, Scalia-Wilbur J, Legare R, Development of a Discussion/Education Group for BRCA Mutation Carriers in a High Risk Clinic: An Assessment of Patient Interest, Expectations, and Needs. NSGC 28th Annual Education Conference; Abstract Poster presentation, November 2009, Atlanta GA (continued)
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lymph node identification between lymphoscintigraphy and sentinel lymph node dissection in patients with vulvar cancer. Oral presentation at the 30 Annual Meeting NEAGO conference in Booth Bay Harbor, ME, June 2010.
Gynecologic Oncology
Ferlatte C, Scalia-Wilbur J, Kent J, Legare R, Patient Perspectives on an Appropriate Time For Cancer Genetic Counseling and BRCA Testing For Women Diagnosed With Breast Cancer. NSCG 28th Annual Education Conference; Abstract Platform Presentation, November 2009, Atlanta GA Figueredo N, Gass J S, Dizon D S, LaChance J, Reiker C. “Accuracy of office-based ultrasound guided needle biopsies performed by dedicated breast surgeons”. Poster, San Antonio Breast Symposium. December 13, 2009, San Antonio, TX. Scalia-Wilbur J S, Kent J, Legare R, Uterine Papillary Serous Carcinoma in a BRCA2 Non Ashkenazi Jewish Founder Mutation Carrier: A Case Study. National Consortium of Breast Cancers 2009 Conference; Poster Presentation, 2009, Las Vegas NV Hachey K, Scalia-Wilbur J, Kent J, Legare R D, BRCA Carrier Status, Phenotype and Medical Decision-Making Among Hispanic BRCA Positive Women. National Consortium of Breast Centers 2009 Conference, Abstract Platform Presentation, 2009, Las Vegas NV Sikov W, Dizon D S, Strenger R, Legare R, Theall K, Graves T, Gass J, Kennedy T, Fenton M; Frequent Pathologic Complete Responses In Aggressive Stage II-III breast cancers with q4week carboplatin and weekly paclitaxel ± trastuzumab: a Brown University Oncology Group Study, 2009. Olson C, Dizon D S, Stuckey A, MacLauglin S, Sakr B, Brard L, Legare R D. Outcomes for Women with Cancer receiving Bevacizumab in an Academic Women’s Oncology Program. SGO 41st Annual Meeting on Women’s Cancer. San Francisco, CA. March 14-17, 2010. Olson C, Dizon D S, Kristjandottir K, Kawar N, Bandera C, Sakr B, Legare R D, DiSilvestro P A. Tumor Marker Response in Women Treated with Bevacizumab. SGO 41st Annual Meeting on Women’s Cancer. San Francisco, CA. March 14-17, 2010. Stuckey A , Kim K K, Singh R K, Fischer A, Miller D, Hillenmeyer S, Ritz A, Raphael B, Brodsky A S, Brard L. Developing an Integrated Genomic Approach to Explore the Antitumor Activity of Vitamin D and Derivatives to Treat Ovarian Cancer. 41st Annual Meeting of the Society of Gynecologic Oncologists, San Francisco, CA, March 14-17, 2010. Horowitz N, Olawaiye A, Growdon W, Borger D, Dizon D S, Brard L, Matulonis U, MacNeill K, Roche M, Krasner C. Phase II Trial of Tarceva (erlotinib) in Women with Squamous Cell Carcinoma of the Vulva. 41st Annual Meeting of the Society of Gynecologic Oncologists, San Francisco, CA, March 14-17, 2010. Holman L L, Robison K, Lopes V V, Noto R, M. Steinhoff, Moore R. A comparison of sentinel lymph node identification between lymphoscintigraphy and sentinel lymph node dissection in patients with vulvar cancer. Poster presentation at the Society of Gynecologic Oncologists. San Francisco, March 2010. Robison K, Wu L, Eng W, Douangsavanh A, Tejada-Berges T, Raker C, Pinto S, Dizon D S. Cervical Cancer Prevention: Participation and knowledge among Asian American women. Poster presentation at American Society for Colposcopy and Cervical Pathology (ASCCP). Las Vegas, March 2010. Chan J K, Kawar N M, Shin J Y, Osann K, Kapp D S, Chen L M. Demographic and Clinical Characteristics in Women Diagnosed with Uterine Sarcoma. Poster of the 41st Annual Meeting on Women’s Cancer of The Society of Gynecologic Oncology (SGO). March 14-17, 2010, San Francisco, CA. Stuckey A, Kim K, Singh R, Ritz R, Fischer A, Hillenmeyer S, Raphael B, Brodsky A, Brard L. Developing an Integrated Genomic Approach to Explore the Antitumor Activity of Vitamin D and Derivatives to Treat Ovarian Cancer. Society of Gynecologic Oncology Annual Meeting. March 15, 2010, # 396, San Francisco CA
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Jackson A L, Mathews C, Raker C, Steinhoff M, Bandera C, Dizon D S. Accuracy of Preoperative and Intraoperative Pathology Findings in Low Grade Endometrial Cancer. SGO 41st Annual Meeting on Women’s Cancer. San Francisco, California. March 14-17, 2010. Horowitz N, Olawaiye A, Growdon W, Borer D, Dizon D S, Brard L, Matulonis U, MacNeill K, Roche M, Krasner C. Phase II trial of erlotinib (Tarceva) in women with squamous cell carcinoma of the vulva. SGO 41st Annual Meeting on Women’s Cancer. San Francisco, California. March 14-17, 2010. Plenary Presentation. Dizon D S, Myers J, Doan J, Mitra D, Davis K. The economic burden of ovarian cancer in a US managed care database. SGO 41st Annual Meeting on Women’s Cancer. San Francisco, California. March 14-17, 2010. Pandya S, Dizon D S, Gass J S. Should we excise all breast core-biopsy proven papillary lesions? American Society of Breast Surgeons. Las Vegas, NV. April 28-May 2, 2010. MacLaughlan S, Fischer A, Kristjansdottir K, Ritz A, Raphael B, Steinhoff M, Brodsky A, Brard L. Genetics of Primary and Metastatic Ovarian Cancer. 101st Annual AACR Meeting, Washington, DC, April 17- 21, 2010. MacLaughlan S D, Fischer A, Kristjansdottir K, Ritz A, Raphael B, Steinhoff M, Brodsky A S, Brard L. Genetics of Primary and Metastatic Ovarian Cancer. American Association for Cancer Research Annual Meeting; April 17-21, 2010, Washington DC Pandya S V, Dizon D S, Gass J S, Hansen K, “Should we excise all breast core-biopsy proven papillary lesions?”. Poster, American Society of Breast Surgeons Conference. April 28-May 2, 2010 Las Vegas, NV. Dizon D S, Gass J S, Legare R D, Sakr B J, Rizack T: Is tumor board relevant submitted for the 2010 ASCO Annual Meeting, June 4-8-2010 Chicago, IL
INTERNATIONAL Cronin B, Robison K, Moore R, Granai C O, Dizon D S. Long-term use of Pegylated Liposomal Doxorubicin in recurrent ovarian carcinoma. Poster presentation at European Society of Gynecologic Oncologists. Belgrade, Serbia. October 2009. Makhija S, Dizon D S, Walker R A, Amler L, Loecke D, Venturi M, Kaye S. Pertuzumab in low HER3 mRNA expressing platinum-resistant ovarian cancer. ESGO 2009 Meeting. October 16, 2009. Belgrade, Serbia. Cronin B, Dizon D S. Long-term use of pegylated liposomal doxorubicin in recurrent ovarian cancer. ESGO 2009 Meeting. October 16, 2009. Belgrade, Serbia. Stuckey A, Schwartz J, Dizon D S. Pegylated liposomal doxorubicin in recurrent serous carcinoma of the uterus. ESGO 2009 Meeting. October 16, 2009. Belgrade, Serbia. Cronin B, Robison K, Granai C O, Moore R G, Dizon D S. Stopping at progression or at best response: A study of pegylated liposomal doxorubicin in women with recurrent gynecologic cancer treated at an academic women’s oncology program. European Society of Gynecologic Oncologist Annual meeting, Belgrade, Serbia, October 11-14, 2009
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Dizon D S, Myers J, Doan J, Mitra D, Davis K. The Economic Burden of Ovarian Cancer in a United States Managed Care. SGO 41st Annual Meeting on Women’s Cancer. San Francisco, California. March 14-17, 2010.
Gynecologic Oncology
INVITED PRESENTATIONS (LOCAL/REGIONAL) Cain, JM. Moderator: “Moving into the Future: New Dimensions and Strategies for Women’s Health Research for the National Institutes of Health.” Providence, RI, September 2009 Cain, JM. “Safety and Quality Agenda for Ob/Gyn.” Sunshine Seminar, San Juan, Puerto Rico, February 2010. Cain, JM. “Management of Ovarian Cancer.” Sunshine Seminar, San Juan, Puerto Rico, February 2010. Cain, JM. “Cervical Cancer Control: The Challenge and the Hope.” Grand Rounds Presentation: Weill Cornell Medical College, Lincoln Hospital, Jamaica Hospital, New York, NY, March 2010. Cain, JM. “10 Key Things Every ER Should Know About Women’s Cancers.” Grand Rounds, Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, April 2010. Cain, JM. “Mentors, Mentoring, and Career Strategies for all Settings: Community to Academic.” ACOG 58th Annual Clinical Meeting, San Francisco, CA, May 2010. Cain, JM. “Who Are We Really? The Future of Obstetrics and Gynecology.” The 24th Annual Resident & Fellow Research Day & Richard E. Hunter, MD Lecture, UMass Memorial Health Center, University of Massachusetts Medical School, Worcester, MA, June 2010. Ekaterini Tsiapali, MD - “Breast Surgery and Reconstruction” presented at the Breast Cancer Support Group in the Breast Health Center….July 16, 2009 Richard Moore, MD – “Risk Assessment of a Pelvic Mass for Ovarian Cancer” at Falmouth Hospital, July 17, 2009 Ekaterini Tsiapali, MD - “Surgical Treatment of Breast Cancer (NSABP B04 and B06)” presented Breast Educational Rounds to the medical students and fellows…July 17, 2009 Tina Robison, MD - “Mesenchymal Tumors” presented core lecture to the residents and medical students at WIH. July 17, 2009 Tina Robison, MD - “How to Write an Abstract” presented to the fellows at One Blackstone Place. August 7, 2009 Skip Granai, MD - “Things Could Be Worse, We Could Always Be A Community Hospital” presented to Pediatrics Department, WIH; August 12, 2009. Skip Granai, MD – Speaker, Network Regional Physician Leaders/Advisors Team Meeting “Strategy Development and Marketing, SWOT Analysis” WIH, August 12, 2009. Trevor Tejada-Berges, MD - “Why should we care about racial disparities?”- Patient & Advisory Council meeting- Aug 13, 2009 Tina Robison, MD - “Prevalence of HPV and Type Distribution in Southeast Asian Women Residing in Rhode Island” presented research proposal to the WRHR committee. August 17, 2009 Skip Granai, MD - Speaker, Network Regional Physician Leaders/Advisors Team Meeting, Women & Infants Hospital, “Organization and Geography.” August 18. 2009. Robert Legare, MD – Presented at the “Kick-Off” Breakfast for Making Strides for Breast Cancer – August 20, 2009 44
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Robert Legare, MD – presented “Got Milk – Vitamin D and Breast Cancer” at the Breast Health Lecture Series – September 8, 2009
Trevor Tejada-Berges, MD - Presented Screening and Management of Breast Cancer “OB GYN clerkship rotation- Sept 10, 2009 Tina Robison, MD – “Vulva Carcinoma” presented core lecture to the residents and medical students at WIH. Sept. 11, 2009 Ekaterini Tsiapali, MD – “Oncoplastic Techniques in the Management of Breast Cancer” presented to the Fellows at WIH September 11, 2009. Jennifer Scalia-Wilbur, MS - “Hereditary Breast and Ovarian Cancer: BRCA Testing and Beyond.” Directed, coordinated and lectured at the program’s first symposium, Women & Infants Hospital, Providence, RI, September 26, 2009. Jennifer Gass, MD - “Surveillance and Surgical Option for Breast Cancer Risk Reduction” Speaker at the Hereditary Breast and Ovarian Cancer: BRCA Testing and Beyond, Women & Infants Hospital, September 26, 2009. Bachir Sakr, MD – “Use of Tamoxifen (B14 and B12)” presented to the Breast/GYN Fellows at WIH October 9, 2009. Don Dizon, MD - You’ve Lost that Loving Feeling: Sexual Health and Breast Cancer Survivors. Breast Cancer Survivors’ Day. October 15, 2009, Greenfield, MA. Jennifer Gass, MD - “A New Legacy of Knowledge, Choice and Beauty” Invited speaker: Festival Ballet Providence Legacy of Loss in recognition of Breast Cancer Awareness Month. Festival Ballet Providence, Providence, RI, October 18, 2009. Trevor Tejada-Berges, MD – Presented ”Why Should We Care About Racial/Ethnic Disparities in Health Care?” Woonsocket MOB Annual Community celebration- October 22, 2009 Jennifer Gass, MD – “Sentinel Lymph Node Biopsy” lecture to the Fellows at WIH October 23, 2009. Jennifer Gass, MD - “New Surgical Option, Including Nipple Sparing Mastectomy and Oncoplastics” speaker: at Breast Health Center Fair: Inside the Breast Health Center a place for health, wellness and healing. Women & Infants Hospital, Providence, RI, October 30, 2009. Robert Legare, MD – presented on breast and ovarian disease at the Women & Infants’ Symposium on “Tsunami of Genetics”; November 7, 2009 Jennifer Scalia-Wilbur, MS - “Identifying Patient with Hereditary Colon Cancer: How it Can Make a Difference the Tsunami of Genetics in Women’s Health: What you need to know, Rhode Island Hospital, Providence, RI November 7, 2009. Jennifer Scalia-Wilbur, MS – didactic lecture to the Fellows on Hereditary Colon Cancer; November 12, 2009 Ekaterini Tsiapali, MD - “Screening and Management of Breast Cancer” presented to the medical students at the main hospital on the 3rd floor conference room. November 13, 2009 Jessica Kent, MS, CGC - “ National Society of Genetic Counselors: AEC 2009 Update Lecture” Women & Infants’ Hospital, Providence, RI , November 24, 2009. (continued) Annual
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Skip Granai, MD - Keynote speaker, First Annual Ovarian Cancer Research Fund’s Super Luncheon, hosted by First Lady Suzanne Carcieri, at the University Club, Providence, Rhode Island (September 9, 2009)
Gynecologic Oncology
Trevor Tejada-Berges, MD - Presentation on a Core Lecture “Hereditary Breast and Ovarian Cancer” Women and Infants hospital of RI- Jan 8, 2010 AnnMarie Bradley, RN, BSN, OCN, presented to the staff at Butler Hospital on “Ovarian Cancer – Progress in Detection, Diagnosis, Staging, and Treatment” – January 13, 2010. Ekaterini Tsiapali, MD - “BHC Research/Publication” presented to the Fellows at WIH, January 18, 2010 Nada Kawar, MD - Women’s Health Lecture Series: What women should know about Cervix Cancer. Women & Infants’ Hospital/Brown University, January 19, 2010. Robert Legare, MD – RI Hospital Grand Rounds “Breast and Ovarian Cancer Syndrome” – January 28, 2010 Jessica Kent, MS, CGC - “ Hereditary Gynecological Cancer Syndromes” Fellowship Lectures. Women & Infants’ Hospital, Providence, RI, February 5, 2010. Paul DiSilvestro, MD – presented at the Ovarian Cancer Research Symposium at Brown University “Ovarian Cancer Treatment: What Have We Learned, What We Don’t Know.” – February 5, 2010 Ekaterini Tsiapali, MD - presented “Bowel Repair” at the Core Curriculum lecture at WIH, February 26, 2010 Don Dizon, MD - Ovarian Cancer: Novel Treatments and Current Paradigms. Rhode Island Hospital Cancer Center Grand Rounds, Rhode Island Hospital, March 11, 2010. Skip Granai, MD - Invited Speaker, Chemotherapy Certification Course, Women & Infants Hospital, Providence, RI. April 19th, 2010. Trevor Tejada-Berges, MD - Presented: Breast Talk ”Margin Status and DCIS meta Analysis” at the Fellow Meeting- April 23, 2010 Jessica Kent, MS, CGC - “ Hereditary Colon Cancer Syndromes” Lecturer, Clinical Cancer Genetics Medical Elective, Alpert Medical School, Brown University/ Women & Infants’ Hospital, Providence, RI, April 29, 2010. Richard Moore, MD – presented “A Novel Biomarker for the Management of Women with Epithelial Ovarian Cancer” at the American Society of Clinical Lab, Providence RI; May 4, 2010 Ekaterini Tsiapali, MD – presented “Thyroid and Colon Management: to the Woonsocket area community at the WIH MOB May 4, 2010. Skip Granai, MD - Keynote speaker at the Oncology Nursing Society Local Chapter, Hasbro Children’s Hospital, Providence, RI. “We Can Always Dance.” May 5, 2010. AnnMarie Bradley, RN, BSN, OCN – presented Gynecologic Cancers “We Can Always Dance” to the Oncology Nursing Society Staff at RIH on May 5, 2010. Robert Legare, MD – presented a didactic lecture entitled “Hereditary Breast and Ovarian Cancer Syndromes” to the genetics elective students on May 6, 2010. Ekaterini Tsiapali, MD – presented at Newport Hospital Grand Rounds “Breast Cancer Screening and Risk Reduction” on May 7, 2010. Skip Granai, MD - Keynote Speaker, Program in Women’s Oncology’s Integrative Care Open House, at South County Common, Wakefield, RI. “If I Were You and You Were Me.” May 8, 2010 46
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Don Dizon, MD – gave a presentation on Breast Screening and Mammography Controversy Debate at the Annual Scientific meeting, Warwick RI; May 13, 2010.
Trevor Tejada-Berges, MD - Core Lecture:”Cervical Caner Diagnosis and Management”- May 14, 2010 Christina Bandera, MD – gave a Robotic Surgery Lecture as part of the Curves Lecture Series, Attleboro MA; May 14, 2010. Robert Legare, MD – Westerly Hospital Grand Rounds, “Epithelial Ovarian Cancer: Present Treatment/Controversies and Future Directions” Westerly Hospital, Westerly RI, May 20, 2010. Don Dizon, MD – RI Hospital Grand Rounds – “Sex and Intimacy in Female Cancer” – May 20, 2010. Trevor Tejada-Berges, MD - OB-GYN Clerkship – “Screening and Management of Breast Cancer” May 27, 2010 Trevor Tejada-Berges, MD – gave a presentation as part of the Curves Lecture Series, Franklin MA; May 27, 2010 Jennifer Gass, MD - “Breast Cancer in the New Millennium” Staff Development Day, Alpert School of Brown University, Providence, Rhode Island, June 3, 2010. Skip Granai, MD - Invited Speaker, Westerly Hospital, Grand Rounds, “Women’s Cancers: What are we thinking?” June 6, 2010. Ekaterini Tsiapali, MD - presented Breast Health Center lecture “Breast Cancer Screening and the perioperative use of MRI” on June 8, 2010. Richard Moore, MD – presented “HE4 Update” to the Fall River physicians in North Dartmouth, MA, on June 10, 2010 AnnMarie Bradley, RN, BSN, OCN – presented “Gynecologic Cancers” to the clinical staff at William Backus Hospital in CT on June 24, 2010
INVITED PRESENTATIONS (NATIONAL) Don Dizon, MD - Con: Bevacizumab should be continued indefinitely and utilized with every drug regimen for recurrence. GOG Summer Symposium, July 16, 2009, Baltimore, MD. Trevor Tejada-Berges, MD - Presentation” What is the OB/GYN to do?”- Florida Obstetrics and Gynecologic Society conference, Boca Raton Florida –August 14-15, 2009 Don Dizon, MD - Ovarian Cancer: State of the Art and Current Controversies. University of Miami Sylvester Cancer Center Grand Rounds, September 8, 2009, Miami, FL. Skip Granai, MD - Keynote speaker, 8th Annual Nixon Lectureship, sponsored by The University of Kentucky/Norton Healthcare Foundation, held at the Olmsted, Louisville, KY. “We Can Always Dance.”(September 21, 2009) Skip Granai, MD - Keynote speaker, Bassett Healthcare Interdepartmental, Grand Rounds. Clark Education Building, Bassett Campus, Cooperstown, New York, Wednesday, October 7, 2009. “We Can Always Dance.” (October, 2009) (continued)
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Trevor Tejada-Berges, MD - Presented: “Brining Robotic Surgery To Women & Infants Hospital”- May 13, 2010
Gynecologic Oncology
Don Dizon, MD - Session Co-Chair: Challenges in Survivorship. 2009 ASCO Breast Symposium. October 8, 2009, San Francisco, CA. Jennifer Scalia-Wilbur, MS – “Hereditary Breast Cancer: Breast Cancer in Younger Women” presented at the Breast Cancer in Younger Women Nursing Education Conference, New York, NY; November 4-5, 2009. Don Dizon, MD - Moving Beyond Standard of Care: Novel Treatments in Gynecologic Malignancies. Chemotherapy Foundation Symposium. November 11-13, 2009, New York, NY. Skip Granai, MD - Invited Speaker, Fall Society of Gynecologic Oncologists Executive Council Meeting in Washington, DC. “Bringing together the best in Women’s Cancer Care.” (November, 2009) Skip Granai, MD - Invited speaker, the Society of Gynecologic Oncologist 41st Annual Meeting on Women’s Cancer, Sunday, March 14th, Moscone Convention Center, San Francisco, CA. “Incorporating Breast Care into Clinical Practice – Developing a Breast Fellowship Training Program, 2010. Skip Granai, MD -Invited Speaker, Vice President Report of the Society of Gynecologic Oncologists Business Meeting, Monday, March 15th, Moscone Convention Center, San Francisco, CA. “SGO Strategic Goal Accomplishments”, 2010. Skip Granai, MD - Invited Speaker, introduced the Society of Gynecologic Oncologists’ President, David Mutch, MD at the SGO’s Presidential Address Event, Monday, March 15th, Moscone Convention Center, San Francisco, CA. SGO’s Presidential Address, 2010. Don Dizon, MD - Current Strategies in the Treatment of Platinum-Resistant Recurrent Ovarian Cancer. Clinical Advances in Gynecologic Malignancies. An Industry Satellite Sponsored Symposium at the Society of Gynecologic Oncologists Annual Meeting, March 15, 2010. San Francisco, CA. Don Dizon, MD - National Consortium of Breast Centers Annual Meeting, March 19-24, 2010, Las Vegas, NV. 1. Session Moderator, Opening Plenary Sessions, March 21, 2010. 2. Golden Girls: The Approach to Breast Health in Women over 70. March 22, 2010. 3. Panelist, Approaching Metastatic Breast Cancer. March 23, 2010 Jennifer Gass, MD - “I want a Bilateral Mastectomy and Urban Unrest: The Breast Center in Academia” Speaker: at the National Consortium of Breast Centers 20th Annual Interdisciplinary Breast Center Conference. Los Vegas, NV, March 20-24, 2010. Trevor Tejada-Berges, MD - Attended Prep Course for Breast Ultrasound and Stereotactic at American Society of Breast Surgeons, Las Vegas, NV April 29, 2010- Has completed prep course and has received a certification of completion. Richard Moore, MD – presented “A Novel Approach to Pelvic Mass Risk Assessment for Ovarian Cancer” at the Resident Research Day at the University of Rochester in NY; May 13, 2010. Skip Granai, MD - Invited Speaker, Gynecologic Cancer Foundation’s Ovarian Cancer Survivors Course, at NYU Langone Medical Center, New York, NY. Title: Phenomenal Women: Ovarian Cancer Survivorship” May 15, 2010. Skip Granai, MD - Keynote Speaker, University of Pennsylvania, Brett Gutsche Lecture. Title: “We Can Always Dance.” May 20, 2010. Skip Granai, MD - Keynote Speaker at “The Female Patient” Conference: Current Issues in the Care of Women – Isla Grand Beach Resort, South Padre Island, Texas. ”We Can Always Dance.” June 14, 2010. 48
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INVITED PRESENTATIONS (INTERNATIONAL) Cain, JM. “Common Cancers Specific to Women: New Developments & Hope.” Women Deliver Conference (International), Washington, DC, June 2010. Cain, JM. “Can we eliminate cervical cancer globally.” Women Deliver Conference (International), Washington, DC June 2010. Don Dizon, MD - Ville Marie Oncology Center 15th Anniversary Breast Cancer Conference. Breast Cancer: Progress in prevention, detection, and treatment. August 4, 2009, Montreal, Quebec, Canada. 1. Current options in chemoprevention. 2. Progress in hormonal and chemotherapy agents. 3. You’ve lost that loving feeling: Sexual health and the breast cancer survivor. Richard Moore, MD – presentation titled “Tumor Markers in Gynecologic Cancers” at the European Society of OB-GYN meeting, Rome Italy. September 9-13, 2009. Tina Robison, MD – Poster presentation “Stopping at Progression or at Best Response: A study of Pegylated Liposomal Doxorubicin in Women with Recurrent Gynecologic Cancer Treated at an Academic Women’s Oncology Program” at the European Society of Gynecologic Oncology meeting, Belgrade, Serbia, October 10-14, 2009 Richard Moore, MD – presented “Pelvic Mass Risk Assessment” at the European Society of Gynecologic Oncology meeting, Belgrade, Serbia, October 11-14, 2009. Skip Granai, MD -Invited Speaker: 3rd Asia Pacific Congress: Controversies in Obstetrics, Gynecology, & Infertility, Shangri-La’s Kerry Centre Hotel, Beijing, China. Pelvic mass in pregnancy: When do we need to Intervene? (November, 2009) Skip Granai, MD - Chairperson/discussant” 3rd Asia Pacific Congress: Controversies in Obstetrics, Gynecology, & Infertility, Shangri-La’s Kerry Centre Hotel, Beijing, China (November, 2009) Skip Granai, MD - Hot Controversies – Expert Opinion on: Cervical Cancer and Human Papilloma Virus (HPV): Does vaccination mark the end of cervical cancer? Shangri-La’s Kerry Centre Hotel, Beijing, China (November, 2009) Skip Granai, MD - Keynote Speaker: 3rd Asia Pacific Congress: Controversies in Obstetrics, Gynecology, & Infertility, Shangri-La’s Kerry Centre Hotel, Beijing, China. “Voices” (November, 2009) Richard Moore, MD – Chairperson – Women and Ovarian Cancer: From Conception to Diagnosis “Early Diagnosis of Ovarian Cancer Can Improve Prognosis” at 3rd Asia Pacific Congress: Controversies in Obstetrics, Gynecology, & Infertility, Shangri-La’s Kerry Centre Hotel, Beijing, China (November 2009) Richard Moore, MD – served as a discussant on “Hot Controveries – Expert Opinion on: Cervical Cancer and Human Papilloma Virus (HPV): Does Vaccination Mark the End of Cervical Cancer?” at 3rd Asia Pacific Congress: Controversies in Obstetrics, Gynecology, & Infertility, Shangri-La’s Kerry Centre Hotel, Beijing, China (November 2009) Richard Moore, MD – presented “HE4 in Ovarian Cancer,” Istanbul, Turkey Katrin Kristjansdottir, MD - Development of Tumor Markers In Ovarian Cancer. Grand Rounds. Landspitali University Hospital, Iceland Department of Ob/Gyn. January 21. 2010 Annual
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Skip Granai, MD - Keynote Speaker, “The Female Patient” Conference: Current Issues in the Care of Women - Isla Grand Beach Resort, South Padre Island, Texas. “Ovarian Masses During Pregnancy.” June 15, 2010.
DIVISION OF MATERNAL–FETAL MEDICINE INTRODUCTION
Maternal–Fetal Medicine
The mission of the Division of Maternal–Fetal Medicine is: (1) to provide the highest quality consultative and patient care pregnancy–related services to health professionals and patients; (2) to develop new knowledge about physiology, mechanisms of disease and clinical practice related to pregnancy; (3) to train medical students, residents and fellows to be future leaders in health care.
FACULTY Katharine D. Wenstrom, MA, MD, Division Director, joined the staff at Women & Infants Hospital of Rhode Island as director of the Division of Maternal-Fetal Medicine and Professor of Obstetrics and Gynecology on July 1, 2009. Dr. Wenstrom received both her BA and her MD from Case Western Reserve University in Cleveland, Ohio, and an MA in Pathology from Columbia University in New York City, New York. She completed her residency training and her fellowship in Maternal Fetal Medicine at the University of Illinois in Chicago, followed by a fellowship in Medical Genetics at the University of Iowa. Dr. Wenstrom has served as president of the Society for Maternal-Fetal Medicine, as a member of the executive board of the American College of Obstetricians and Gynecologists, and as head of the National Institutes of Health Obstetrics and Maternal-Fetal Biology Subcommittee. She has been editor-in-chief for obstetrics of the Obstetrical and Gynecological Survey since 2005. Her clinical and research interests include genetic screening, fetal diagnosis and therapy, and teratology. Brenna L. Anderson, MD, MS joined the faculty in July, 2006 as Assistant Professor of Obstetrics and Gynecology. She received her BS from the University of RI and her MD from Brown University. She completed her Ob/Gyn and MFM training at the University of Pittsburgh. She also received a Master’s degree in clinical research and completed a fellowship in Reproductive Infectious Diseases and Immunology at the University of Pittsburgh. Her clinical and research interests focus on the ante – and intra-partum care of infectious diseases in pregnancy, and she is the chief of the Reproductive Infectious Diseases consultative service here at WIH. In 2006, Dr. Anderson was selected for the Women’s Reproductive Health Research (WRHR) Career Development Program at Brown University, which supported her investigations of the immune system in pregnancy. In 2009, she received a K23 Mentored Patient-Oriented Career Development Award to study mucosal immunity in the acquisition of HIV . Dr. Anderson has served as the leader of the Infectious Disease Special Interest group for the Society for Maternal Fetal Medicine, and is currently the alternate PI for the NIH MFMU Network.
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Stephen R. Carr, MD joined the faculty in 1988 after completing his Maternal–Fetal Medicine fellowship here at WIH, and is currently a Professor of Obstetrics and Gynecology. He graduated from Middlebury College and received his MD from the University of Hawaii. He completed his residency training at the University of Illinois in Chicago. Dr. Carr’s clinical interests include fetal sonography and invasive Center and Maternal–Fetal Medicine Diagnostic Imaging at Women & Infants Hospital of Rhode Island and Co-Director of the Fetal Treatment Program, a co-operative effort of Women & Infants Hospital of Rhode Island and Lifespan. His research interests include evaluation and management of twin-to-twin transfusion syndrome. Dr. Carr is a Colonel in the Rhode Island Air National Guard and is Commander of the 143rd Medical Group, and recently returned from a three-month mission in Afghanistan. Edward K. S. Chien, MD joined the Division of Maternal–Fetal Medicine in 2004 as an Assistant Professor of Obstetrics and Gynecology. He graduated from the University of Illinois in Urbana and received his MD from the University of Illinois in Chicago. He completed his residency training in 1992 at the University of Michigan Medical Center. He completed his Maternal Fetal Medicine fellowship at the University of Chicago in 1994, and then undertook a 3 year postdoctoral fellowship in the laboratory of Graeme I Bell in the Department of Molecular Biology and Biochemistry, funded through the Reproductive Scientist Development Program as the March of Dimes Fellow. Dr. Chien joined the faculty at the University of Vermont in 2002, where he served as MFM fellowship director After joining the MFM division here at WIH in 2004, Dr. Chien became the Maternal Fetal Medicine Fellowship director in July of 2005. His research interests focus on understanding the mechanisms responsible for prematurity, focusing on cervical remodeling and maternal physiology. Donald R. Coustan, MD joined the faculty as Director of Maternal–Fetal Medicine in 1981, was appointed Professor of Obstetrics and Gynecology in 1986, and was Chairman of the Department from 1991 to 2008. After retiring from this role, he kindly agreed to serve as Interim Division Director of Maternal-Fetal Medicine from March 2008 until July 1, 2009, when Dr. Katharine Wenstrom assumed the position of permanent Division Director. Dr. Coustan continues to be a clinically active member of the MFM division, providing antenatal care to women with diabetes. His research interests have been focused on the epidemiology of gestational diabetes and its treatment. Tanya Dailey, MD joined our division in July 2009 as a clinical Assistant Professor of Obstetrics and Gynecology. She received her BS degree in Human Physiology from Boston University and completed both medical school and residency at Tufts New England Medical Center and University. She did her Maternal Fetal Medicine Fellowship here at Women and Infants Hospital, with a thesis on TGF expression in the pregnant rat cervix and its role in cervical remodeling. Her research interests include pre-term labor and cervical insufficiency. (continued)
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diagnostic and therapeutic techniques. He is the Director of the Prenatal Diagnosis
Matthew Esposito, MD joined our division in early 2010. He received his BA in Biology from Williams College and his MD from the University of Rochester. After completing his residency at the University of Maryland, he did his Maternal Fetal Medicine Fellowship here at Women and Infants Hospital. He was then an As-
Maternal–Fetal Medicine
sistant Professor at the University of Massachusetts Memorial Medical System, where he established himself as an expert in prenatal ultrasound and resident and medical student teaching. Dr Esposito’s research interests include aspects of cesarean delivery and clinical problems in obstetrics. Barbara M. O’Brien, MD joined the faculty in 2007 as Assistant Professor of Obstetrics and Gynecology. She received her BA from the College of the Holy Cross and her MD from New York Medical College. She received her OB/GYN and MFM training at Tufts New England Medical Center. She also completed a Medical Genetics Fellowship at Tufts New England Medical Center in 2007. She is the Director of Perinatal Genetics and Co-Director of the Prenatal Diagnosis Center at Women and Infants Hospital of Rhode Island. She is also the Associate Director of the Core Clerkship in Ob/Gyn and is in charge of the resident rotation in MFM. Her clinical interests include fetal sonography, invasive techniques for the diagnosis of chromosomal and genetic disorders, and the diagnosis and treatment of twin-to-twin transfusion syndrome. Michael Paglia, MD, PhD joined the faculty in 2005 as a Clinical Assistant Professor of Obstetrics and Gynecology. He graduated from College of the Holy Cross, received his MD from the University of Pennsylvania and his PhD from Johns Hopkins Bloomberg School of Public Health with a focus in Health Services Research. At Hopkins he received a Commonwealth Fund Dissertation Award. He completed both his Ob/Gyn and MFM training at Duke University Medical Center. In November 2009, Dr. Paglia left WIH to become MFM division director at the Geisinger Medical Center in Wilkes Barre, Pennsylvania. However, he has retained his academic appointment here and returns several times each month to continue his research, which is focused primarily on resident education and patient safety issues.
FELLOWS Julie Johnson, MD received her undergraduate degree from UNC Chapel Hill and her MD from Wake Forest University. After completing her residency at the University of South Carolina, she came to Women and Infants Hospital for her Maternal Fetal Medicine Fellowship. Her research and clinical interests include fetal cardiac function in growth-restricted pregnancies and mechanisms and abnormalities of labor and delivery. She will be joining the Women & Infants’ MFM division in August, 2010. Hector Mendez-Figueroa, MD Is the current first year fellow. He received his MD from the Universidad Nacional Autonoma de Honduras, and completed his residency at Baylor College of Medicine. His research interests include premature rupture of the membranes and OTC deficiency in pregnancy. 52
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Nicole Sprawka, MD is the third year Maternal Fetal Medicine fellow. She received her undergraduate degree from the University of Texas and her MD from the University of Texas Southwestern. She completed her residency at Baylor College of Medicine in Houston, Texas. She is working with the Department of Laboratory and Pathology to study prenatal screening for chromosomal abnormalities.
sity of Texas in Austin and his MD from Texas A and M College of Medicine. He completed his internship at Beth Israel Medical Center in New York City, and his residency at Baystate Medical Center in Springfield, Massachusetts, after which he spent two years as an Assistant Professor at Tufts University School of Medicine. He is currently studying the relationship between maternal diabetic control and fetal cardiac defects.
RESEARCH Brenna Anderson, MD, MS was selected in 2006 for the Women’s Reproductive Health Research (WRHR) Career Development Program at Brown University, which supported her investigation of the host immune system in pregnancy, and in 2009 received an NIH K23 Mentored Patient-Oriented Career Development Award to study mucosal immunity in the acquisition of HIV. She was also awarded a Center for AIDS Research Developmental grant to study the effect of treatment of trichomoniasis on genital shedding of HIV in South Africa. She is engaged in several research studies examining the immune response to HIV infection and other sexually transmitted infections, as well as normal vaginal immunology and bacteriology. She has also examined the impact of the novel swine-origin influenza A virus on pregnant women. In 2009 she became the alternate principal investigator for the Maternal–Fetal Medicine Units Network. This year the Network approved her multicenter study examining the impact of hyperimmune globulin on the prevention of congenital cytomegalovirus, and she will head the CMV study subcommittee. Edward Chien, MD has focused his research on cervical mechanisms of pre–term birth, examining the molecular remodeling response to mechanical stress and strain. Dr. Chien collaborates with bioengineers and investigators at Brown, MIT, the University of Illinois and Tufts, evaluating models to understand tissue responses to force. He is examining extracellular matrix components, including collagen, elastin, and proteoglycans, that provide structural integrity responsible for resisting mechanical forces. Radiofrequency spectral analysis, molecular and biochemical techniques are combined to understand how the cervix contributes to successful pregnancy outcomes. His research objectives include developing structure/composition function relationships in cervical tissue and examining the effects of pharmacological agents known to affect cervical mechanics. Dr. Chien was recently awarded an NIH R03 grant to study the effects of force and the hormonal environment on the cervical matrix, and has also been awarded an NIH contract to perform part of the Normal Fetal Growth Study.
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Roman Starikov, MD is the current second year fellow. He received his BS from the Univer-
Donald R. Coustan, MD serves as the site principal investigator for the Stillbirth Collaborative Research Network, which was established to examine the epidemiology, clinical correlates, and pathogenesis of stillbirth. The network is engaged in the study of a geographically determined racially mixed population–based sample of 500 to 700 stillbirths and an age-matched sample
Maternal–Fetal Medicine
of pregnancies productive of liveborn infants. Dr. Coustan also serves as the North American Regional Director of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, an international observational cohort study of 25,000 gravidas, the results of which are expected to change the way gestational diabetes is diagnosed throughout the world. Julie Johnson, MD is joining our faculty in August 2010. Her research interests include normal and abnormal labor and delivery and treatment of cervical Insufficiency. Barbara O’Brien, MD has focused her research on various aspects of fetal diagnosis and therapy. One current project involves using proteomic profiling to identify novel biomarkers in blood and amniotic fluid from women carrying fetuses with twin-to–twin transfusion syndrome, a project made possible by the number of patients with TTTS referred to the Brown Fetal Treatment Program. She hypothesizes that there are novel biomarkers in maternal serum and amniotic fluid, both before and after laser ablation treatment for severe TTTS, that may both illuminate the etiology and predict the severity of this devastating disorder. Dr. O’Brien has established collaborations with Dr. Francois Luks, from the Division of Pediatric Surgery, and Dr. Djuro Josic, Director of Proteomics Core, COBRE Center for Cancer Research Development, as well as with colleagues at Yale University in order to accomplish this goal. Dr. O’Brien’s other research interests include novel methods to incorporate teaching of medical genetics training into resident and fellow training. Katharine Wenstrom, MA, MD has concentrated her research on perinatal genetics, including prenatal screening, the role of MTHFR polymorphisms in the development of cardiac and neural tube defects, and various aspects of fetal diagnosis and therapy. Her current research interests include the relationship between folic acid nutriture and post partum depression, and placental damage after CVS as a possible instigator of preeclampsia.
EDUCATION The Division contributes to the education of medical and other students enrolled at Brown University. Maternal–Fetal Medicine faculty members have supported many undergraduate independent study projects. The Division contributes several lectures and individual advising of third year clinical clerkship students. Dr. Chien is the Director of the Brown University/Women & Infants Hospital of Rhode Island Fellowship Program in Maternal–Fetal Medicine. During this academic year the Division supported three fellows in preparation for academic careers in the subspecialty. Our fellows in 2009–10 were: Julie Johnson, MD, Nicole Sprawka, MD, and Roman Starikov, MD. Three quarters of the graduated fellows currently have academic positions. Dr. Johnson completed her fellowship at the end of June 2010 and will join our Division at Women and Infants Hospital. 54
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Our current fellows are involved in interdisciplinary research involving obstetric outcomes, serum marker screening, preterm labor, and diabetes. The division offers research opportunities both at the bench and at the bedside. In addition, the Division supports postgraduate education of residents in Obstetrics and Gynecharge of the resident rotations, and is also Associate Program Director of the Residency. The Division’s clinical conferences include a general obstetrics conference, an MFM case conference and the Multi–disciplinary Antenatal Diagnosis and Management Conference (MADAM). Basic orientation in sonography and in amniocentesis for Ob/Gyn residents is offered, and residents also rotate through the Prenatal Diagnosis Center, where they get additional experience in prenatal ultrasound. Medical student preceptors: MFM faculty served as preceptors for 17 medical students during their core clerkship in Obstetrics and Gynecology during 2009-2010 academic year. Medical school course leadership and participation: Dr. Barbara O’Brien continued to serve as Associate Director of the Core Clerkship in Obstetrics and Gynecology this year. Dr. Carr is course director for the Maternal–Fetal Medicine Clinical Elective Biomed 491, which accommodated eight medical students this year. MFM faculty provided 24 lectures to students on the core clerkship over the course of the year. Resident and fellow lectures: MFM faculty provided nine core curriculum lectures and three grand rounds lectures to residents in Obstetrics and Gynecology during the past academic year. In addition, Dr. Brenna Anderson is a co-director of the resident research curriculum and regularly participates in lectures and journal clubs. Twenty fellow lecture series presentations were made by MFM faculty. Dr. Carr manages the MADAM conference, held twice monthly. MFM provides a lecture in the noon resident lecture series once per month. All faculty participate in the majority of the Division’s resident conferences. Perinatal management conference: Dr. Chien and all MFM fellows have presented at the Perinatal Management Conference Series of the Neonatology department. Neonatology core lecture series: September 21-13, 2009 Dr. Chien continued to participate in the didactic teaching program for the neonatology fellowship program. Multi–disciplinary antennal diagnosis and management (MADAM) conference: The Brown University Program in Fetal Medicine began in 1997. Dr. Carr is one of its co–Direc(continued)
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cology. There are 7-week rotations in MFM for PG2 and PG4 residents. Dr. Barbara O’Brien is in
tors in addition to Francois Luks, MD, of the Division of Pediatric Surgery at Hasbro Children’s Hospital. The Program in Fetal Medicine presents the Multidisciplinary Antenatal Diagnosis and Management conference (MADAM) twice monthly. Of the more than 55,000 patient encounters at the Prenatal Diagnosis Center over a five-year span, approximately 1% has been
Maternal–Fetal Medicine
referred for consultation with pediatric urology, surgery, cardiology, neurosurgery, genetics, orthopedics or neonatology. During the 2009–2010 academic year, more than 150 cases were referred to MADAM for consensus recommendations among these represented medical specialties. The program continues to develop expertise in antenatal diagnosis and management and in fetal interventions. The Office of Research on Women’s Health (ORWH) Scientific Workshop on New Dimensions and Strategies for Women’s Health Research, September 2009 The division of MFM helped to organize and plan this workshop, designed to identify the most urgent topics for future research in women’s health. Dr. Wenstrom was an invited speaker. The Tsunami of Genetics–Brown Alpert School of Medicine Genetics Course, October 2009 Dr. Barbara O’Brien organized and directed this freestanding CME course on current issues in genetics for practitioners around the state, and Drs Wenstrom and O’Brien contributed lectures. This course was highly regarded and enthusiastically reviewed.
CLINICAL ACTIVITY Inpatient Care: During academic year 2009–2010, the Division managed 834 inpatient admissions to Women & Infants Hospital of Rhode Island, of which 371 were emergent maternal transfers. Maternal–Fetal Medicine performed 522 deliveries. Antenatal Care: The Division provided antenatal care to patients with a variety of maternal medical complications and fetal complications. This unit is managed by a nursing professional coordinator with the help of 2.5 FTE nurses (two of whom are certified diabetes nurse educators) and 2.0 FTE clerical staff who coordinated 2,368 patient visits for 463 new obstetrical patients (14% more than last year). Outpatient Consultation: During the past academic year, the Division provided 339 non–Prenatal Diagnosis Center (PDC) outpatient consultations, 282 PDC–based consultations, 64 New Bedford office consultations, 23 Foxboro office consultations, and 9 Norwich consultations for area physicians. The Division’s diabetes nurse educators provide gestational diabetes classes and individual education on the use of a home glucose meter and/or the preparation and self–injection of insulin. A total of 260 diabetic patients were provided with individual instruction (120% more than last year) and 274 patients attended classes.
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The Prenatal Diagnosis Center The Prenatal Diagnosis Center (PDC) is managed by Dr. Stephen Carr, the Director of the Prenatal Diagnosis Center and Diagnostic Imaging, and Dr. Barbara O’Brien, the Co-Director. The PDC opened in March, 1992 providing an integrated array of antenatal diagnostic services, including: genetic counseling, MFM and clinical genetics consultation, sonographic evaluation of fetal fetal assessment, and parental testing for diabetes and genetic disorders. During academic year 2009-2010, the PDC provided 6,164 imaging procedures, 2,515 antenatal testing visits, 1,009 genetic counseling visits, 282 MFM consultations, 49 CVS procedures, and 125 amniocenteses. The PDC employs seven genetic counselors who provide counseling and integrated evaluation of families and pregnancies at risk for genetically related or other perinatal morbidity. The PDC is supported by an RN manager, another full–time staff nurse, five administrative coordinators, an associate division manager, two financial counselors, a medical assistant and three full time equivalent sonographers, a research sonographer plus a senior ultrasound coordinator. Off–Campus Consultative and Imaging Services MFM provides consultative and imaging support to our outlying communities and providers. These services are offered through our off-site offices in New Bedford, MA and Foxboro, MA and through contracted service agreements with Charlton Memorial Hospital in Fall River, MA and at South County Hospital in Wakefield, RI. In April 2010, a new site was opened in Norwich, CT, which currently provides ultrasound and MFM services 1½ days per week. The New Bedford office now employs a staff of six sonographers, two secretaries, and an administrative coordinator. The Division supports regular physician and genetic counselor services at all of these sites. During academic year 2009-2010 these off-sites provided a total of 2,409 imaging procedures, 142 antenatal testing visits, 429 genetic counseling visits, and 96 MFM consultations.
CLINICAL GENETICS SERVICES Barbara O’Brien joined Women & Infants Hospital of Rhode Island as the MFM Director of Perinatal Clinical Genetics in July 2007, providing oversight of the clinical and educational mission of the Division’s genetics program. Katharine Wenstrom, MD the division director of MFM, is also a clinical geneticist with a national reputation in prenatal genetics and prenatal diagnosis. Office
Number of Genetic Counseling Sessions
Providence
1009
New Bedford
273
Foxboro
156
Charlton Memorial
XX
South County
XX
Norwich
Total
11 1986
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functional and anatomic abnormalities, amniocentesis, chorionic villous sampling, biophysical
ACTIVE RESEARCH SUPPORT Anderson BL: Principal Investigator- Center for AIDS Research (CFAR) Developmental Award “Effect of trichomonas therapy on genital HIV viral burden among African Women.” Funding
Maternal–Fetal Medicine
Agency: Lifespan/Tufts/Brown Center for AIDS Research . Amount: $40,000. Funded: March 1, 2008-2010. Anderson BL: Principal investigator-Grant number 1 K23 HD062340-01. K23 Mentored PatientOriented Career Development Award: “The role of mucosal immunity in risk of HIV acquisition during pregnancy” Funding agency: NIH/NICHD. Funded: August 10, 2009-2013. Chien, EK: Principal Investigator- Grant Number: 1 R03 HD062683-01. Project Title: Effects of force and hormonal environment on cervical matrix. Award Issue Date: 07/12/2010. Chien EK: Co-Investigator – (Barbara McFarlin-PI) 1R21 HD058705-01A2 Biochemical, biomechanical and morphological properties of quantitative ultrasound. NIH R21 Funding period 9/20/2009-8/31/2011. $300,447-Direct/$433,373-Total. Chien EK: Advisor-(Fuson Gundogan-PI). Placental development in fetal alcohol syndrome. NIAAA: K08 AA016783-01. Funding Period 4/1/07-3/20/12. Chien EK: Advisor-(Beatrice Lechner-PI). The role of Biglycan in reproduction. NICHD: K08 HD054676-01A2. Funding Period 1/8/2009-12/31/13. $100,000/108,000: 500k/540k. Cu-Uvin S: 1R25TW008102 (Cu-Uvin) 8/10/08-7/31/2011 1.2 calendar months NIH/FIC $125,000/yr. Interdisciplinary Framework in Global Health at Brown University. Cu-Uvin S: 5U01AI066050 (Friedman) 4/1/2006-3/31/2011 1.2 Calendar Months NIH/NIAID $18,870. S. japonicum and Birth Outcomes: Randomized Controlled Trial. Cu-Uvin S: 2P30AI042853 (C Carpenter) 9/1/1998-6/30/2012 0.6 Calendar Months. NIH/NIAID $111,526 Lifespan/Tufts/Brown Center for AIDS Research HIV and Women’s Core — Co – Director Cu-Uvin S: 1U10AI069472 (Tashima) 12/1/06-11/30/2013 0.24 Calendar Months NIH/NIAID $435,000 Adult Therapeutic Clinical Trials Program for HIV/AIDS Cu-Uvin S: 200-2002-00610 (Carpenter) 9/27/07-9/28/2011 0.3 Calendar Months CDC $424,822 Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN)
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HONORS AND OFFICES Susan Cu-Uvin, MD 2008-present: Editorial Advisory Board, The Open Infectious Diseases Journal 2008: Member, Institute of Medicine, National Academy of Sciences, Committee
Maternal–Fetal Medicine
on Women’s Health Research 2009, April: Chair, Special Emphasis Panel Review, ZRG1 AARR-J 40P, Population and Behavioral Studies in HIV/AIDS 2009, June: Review Panel Special Emphasis Panel Review, ZRG1 BBBP-J (58) and ZRG1 BBBP-L (58) in HIV/AIDS 2009-2013: Member, NIH/NIAID AIDS Research Review Committee Donald R Coustan, MD Treasurer, American Gynecological and Obstetrical Society Katharine D Wenstrom, MD Editor in Chief for Obstetrics, Obstetrical and Gynecological Survey, 2005 to present Editorial Board, American Journal of Perinatology, 2001 to present Advisory Board for Subspecialty Areas, American Journal of Obstetrics and Gynecology, 2002 to present
PEER-REVIEWED PUBLICATIONS Wenstrom K, Erickson K, Schulkin J. Are generalist Ob-Gyns satisfied with their MFM consultants? A survey. AJOG 2009;201(6):S202. Gyamfi, C, Blumenfeld Y, Ramsey P, Foley M, Kilpatrick S, Wenstrom K. The current state of MFM fellowships: results from the SMFM fellow survey. AJOG 2009;201(6):S47. Archabald K, Friedman A, Raker C, Anderson BL. Impact of trimester on morbidity of acute pyelonephritis in pregnancy. Am J Obstet Gynecol, 2009;201:406.e1-4. Broughton DE, Beigi RH, Switzer GE, Raker CA, Anderson BL. Obstetric Health Care Workers’ Attitudes and Beliefs Regarding Influenza Vaccination in Pregnancy. Obstet Gynecol, 2009;114(5): 981-987. Rodriguez E, Raker CA, Paglia MJ, Anderson BL. Assessment of the need for rapid Group B Streptococcus testing during labor and delivery. Am J Perinat, 2010;27(6): 475-9. Luks FI, Carr SR, Muratore CS, O’Brien BM, Tracy TF. The pediatric surgeon’s contribution to in utero treatment of twin-to-twin transfusion syndrome. Annals of Surgery, 250(3):1-7. 2009
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Aagaard-Tillery KM, Malone FD, Nyberg DA, Porter TF, Cuckle HS, Fuchs K, Sullivan L, Comstock CH, Saade GR, Eddleman K, Gross S, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, Bianchi DW, D’Alton ME, for the First and Second Trimester Evaluation of Risk (FASTER) Research Consortium. Role of Second-Trimester Genetic Sonography After Down Syndrome Screening. Obstetrics & Gynecology. 114(6):1189-1196, December 2009. Lambert-Messerlian GM, Palomaki GE, Neveux LM, Chien E, Friedman A, Rosene-Montella K, Hayes M, Canick JA, Early onset preeclampsia and second trimester serum makers. In press Prenatal Diagnosis 29: 2209-17. 2009. Chien EK, Jayakrishnan A, Phipps MG, Dailey TL, Raker CA. Racial and ethnic disparity in male preterm singleton birth. In Press J Reprod Medicine, June 2010. Ji H, Long V, Briody V; Chien EK. Progesterone modulates integrin α2(itga2) and α11 (itga11) in the pregnant cervix. Reproductive Sciences, July 2010 In Press. Coustan DR, Lowe LP, Metzger BE: The hyperglycemia and adverse pregnancy outcome (HAPO) study: can we use the results as a basis for change? Journal of Maternal-Fetal and Neonatal Medicine 23:204-209, 2010. The HAPO Study Cooperative Research Group (Coustan DR, member of writing group): Hyperglycemia and adverse pregnancy outcome (HAPO) study: associations with maternal body mass index. British J ObGyn 117:575-584, 2010. The HAPO Study Cooperative Research Group (Coustan DR, member of writing group): Hyperglycemia and adverse pregnancy outcome (HAPO) study: preeclampsia, Am J Obstet Gynecol 202:255e1-7, 2010. Coustan DR, Lowe LP, Metzger BE: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. Am J Obstet Gynecol 202:654e1-6, 2010. Dudley DJ, Goldenberg R, Conway D, Silver RM, Saade GR, Varner MW, Pinar H, Coustan D, Bukowski R, Stoll B, Koch MA, Parker CB, Reddy U for the Stillbirth Research Collaborative Network: A new system for determining the causes of stillbirth. Obstetrics and Gynecology 116:254-260, 2010. Coustan DR: Finding and treating gestational diabetes – does it help? Nature Reviews: Endocrinology. 6:540-542, 2010. Johnson J. Mersilene versus Ethibond suture efficacy and cerclage. Am J Obstet Gynecol 2009; 201(6):S244. Johnson J, Anderson B, Raker C, Wenstrom K. Elective inductions at term and adverse neonatal outcomes. Am J Obstet Gynecol 2009; 201(6):S124-5. Johnson J, Anderson B, Raker C, Wenstrom K. Timing of delivery with placenta previa: maternal and neonatal outcomes. Am J Obstet Gynecol 2009; 201(6):S74. Johnson J, Long V, Ji H, Chien E. Strain induces collagen production by cervical stromal cells. Am J Obstet Gynecol 2009; 201(6):S74-5. O’Brien BM. Prenatal Management of twin pregnancies: From the Perspective of an MFM/ Geneticist. The Female Patient, 34(12) December 2009. O’Brien BM, Feltovich HM, Carr SR, Luks FI. Feto-Fetal Transfusion Syndrome in Monochorionic Quadruplets. Obstet Gynecol 2010; 115 (2) part 2: 470-472. 60
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O’Brien BM, Wenstrom KD. Down syndrome screening in the First and Second Trimesters of Pregnancy. US Obstetrics and Gynecology 2010 vol 4, 58-65. Kassis N, Jayakrishnan A, Sprawka N, Cu-Uvin S, Anderson BL. Hepatotoxicity and Metabolic Acidosis Manifested as Non-Reassuring Fetal Testing in a Pregnant Woman on Antiretroviral Therapy. Obstet Gynecol, 2010;116: 515–7.
Coustan DR: Examining the Evidence: Is metformin more effective than glyburide for treating gestational diabetes? OBG Management 22:18-21, 2010. Coustan DR: Diabetes mellitus. Precis: Obstetrics (4th edition) Washington, DC: American College of Obstetricians and Gynecologists, 2010. Pp. 133-138.
BOOKS AND BOOK CHAPTERS Wenstrom K. Invasive Fetal Testing: Chorionic Villus Sampling and Amniocentesis. In: Queenan J, Hobbins, Spong C, eds. Protocols for High-Risk Pregnancies, 5th edition. Philadelphia: Wiley-Blackwell, 2010. Wenstrom K. Cardiac Disease. In: Queenan J, Hobbins, Spong C, eds. Protocols for High-Risk Pregnancies, 5th edition. Philadelphia: Wiley-Blackwell, 2010. Wenstrom KD: Precis XIV Prenatal Diagnosis of Genetic Disorders. American College of Obstetricians, 2010. Wenstrom KD: Precis XIV Teratogenic Exposures. American College of Obstetricians, 2010. Wenstrom KD: Precis XIV Preconception Counseling. American College of Obstetricians, 2010. Wenstrom KD: Precis XIV Substance Abuse. American College of Obstetricians, 2010.
INVITED PRESENTATIONS (LOCAL) Wenstrom, KD. Grand Rounds: The Fetal Origins of Adult Disease or Why Obstetrics is the Most Important Specialty. Women & Infants Hospital, Providence, RI. March 4, 2010. Anderson BL. RI Association of Nurses in AIDS Care, 6th Annual Teaching Day, Warwick, RI, “Diagnosis and Management of HIV-1 in Pregnancy” September 25, 2009 Anderson BL. Women & Infant’s Hospital Board of Trustees, “Preparedness for pandemic influenza at Women & Infant’s Hospital” September 29, 2009 Anderson BL. Women & Infant’s Hospital Quality Forum, “Case presentation-peripheral line infection” December 9, 2009 Anderson BL. Women & Infant’s Hospital Union H1N1 Preparedness Day, “Preparedness for pandemic influenza at Women & Infant’s Hospital” December 10, 2009. Chien EK. 14th Annual Neonatology-Pediatric conference, Southcoast Hospitals, Nov 4, 2009, Fall River, MA. Title: PROM at the Borders of Viability (continued)
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NON PEER-REVIEWED PUBLICATIONS
Chien EK. Medical Student Lectures: March 8, 2010. Title: Physiology of Labor BIOL 3674 Human Reproduction Growth and Development Chien EK. Resident Core Lecture: February 5, 2010. Title: IUGR
Maternal–Fetal Medicine
Chien EK. Neonatal Fellows Core lectures: November 5, 2009. Title: IUGR Chien EK. MADAM April 16th, 2010. Title: Trisomy 21 and Congenital Heart Disease Johnson, J. “Thrombophilia and Pregnancy” Women & Infants’ Grand Rounds, Providence RI December 2009 Johnson J. “Preterm Labor Management and the Use of Magnesium Sulfate for CP Prophylaxis” St. Luke’s Hospital Grand Rounds, New Bedford MA, December 2009 O’Brien BM. MADAM October 2, 2009. Title: Fetal Abdominal cysts O’Brien BM. MADAM December 4, 2009. Title: Fetal Patient Round-Up O’Brien, BM. MADAM January 15, 2010. Title: Fetal Patient Round-Up O’Brien BM. MADAM February 5, 2010. Title: Selective Termination in TTTS O’Brien BM. MADAM March 5, 2010- Macrosomia and Overgrowth Syndromes O’Brien BM. MADAM March 19, 2010 Title: FDA Fetal Surgery Protocol for Diaphragmatic Hernia O’Brien BM. MADAM May 7, 2010. Title: Myelomeningocele O’Brien BM. MADAM June 4, 2010. Title: Fetal Patient Round-Up O’Brien BM. MADAM June 18, 2010. Title: Fetal Patient Round-Up O’Brien BM. MADAM August 6, 2010. Title: CCAMs and Other Pulmonary Lesions O’Brien BM. MADAM October 1, 2010. Title: Fetal Patient Round-Up Sprawka N. Anticoagulation in Pregnancy. Current Concepts: Issues in Perinatal & Neonatal Care Conference in Warwick, RI, 2009 Sprawka N. Postpartum Hemorrhage. Intern Lecture Series 2009 Sprawka N. Thalassemia. Maternal Fetal Medicine Resident Lecture 2009 Sprawka N. Elevated Aminotransferases in Pregnancy. Maternal Fetal Medicine Lecture 2009 Sprawka N. Abdominal Wall Defects. Perinatal Management Conference 2009 Sprawka N. Amniotic Band Sequence. Multidisciplinary Antenatal Diagnosis and Management Conference 2009 Sprawka N. Sacrococcygeal Teratoma. Multidisciplinary Antenatal Diagnosis and Management Conference 2009 Sprawka N. Intrauterine Growth Restriction. Perinatal Management Conference 2009
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Sprawka N. Cleft Lip and Palate. Multidisciplinary Antenatal Diagnosis and Management Conference 2010 Sprawka N. Prenatal Diagnosis of Skeletal Dysplasias. Perinatal Management Conference 2010
Wenstrom K. Current Trends and New Direction in Ob/Gyn Seminar: Folic Acid: the Answer to Everything. Mount Auburn Hospital, Waltham, MA. November 18, 2009. Anderson BL. Society for Maternal Fetal Medicine, Infectious Disease and Inflammation Special Interest Group, Leader, 2009-2010. Anderson BL. Work-in-progress Seminar, Cervicovaginal fluid from pregnant and nonpregnant women and in vitro HIV suppression, Dartmouth Medical Center, Laboratory of Charles R. Wira, PhD, January 6, 2010. Anderson BL. Invited participant in National Institute of Allergy and Infectious Diseases, Division of Acquired Immunodeficiency Syndrome meeting, “Mucosal Immunity in the Male and Female Reproductive Tract”, Dartmouth Hitchcock Medical Center, Lebanon, NH, June 30July 2, 2010. Coustan DR. Toward New Criteria for Gestational Diabetes. American Gynecologic and Obstetrical Society, Chicago, October 2009. Coustan DR. Gestational Diabetes Update – 2009. New England Obstetrical and Gynecological Society Fall Meeting, Sturbridge MA, November 2009. Coustan DR. The independent contribution of BMI to outcomes in the HAPO study. GDM Pasadena II: An International Conference on Gestational Diabetes. Pasadena, CA April 2010. (Coustan DR, Metzger BE, Lowe LP, Dyer AE); also moderator of session on pharmacologic management of GDM. Coustan DR. Clinical Seminar: Contemporary Approaches to Diabetes in Pregnancy. American College of Obstetricians and Gynecologists 58th Annual Clinical Meeting, San Francisco, May 2010. Coustan DR. The evolution of perinatal care: a personal perspective. Sloane Academic Assembly of graduating residents and fellows, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York City, June 2010. Coustan DR. Developing new criteria for gestational diabetes. Rosen Lecture, Sloane Symposium. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY. June 2010. Beck NM, Phornphutkul C, O’Brien B, Abuelo DN. A novel heterozygous deletion and insertion mutation in COL1A2 in a family with overlapping features of osteogenesis imperfecta and Ehlers-Danlos syndrome. NSGC AEC, Dallas, TX. October 2010.
INVITED PRESENTATIONS (INTERNATIONAL) Coustan DR. HAPO Update. 9th World Congress of Perinatal Medicine. Berlin, Germany, October 2009. (continued)
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INVITED PRESENTATIONS (NATIONAL)
Sprawka N. Lambert-Messerlian G, Palomaki G, Eklund E, Canick J. The Effect of Oral Antidiabetic Agents on Maternal Serum Alpha-Fetoprotein Levels in Diabetic Pregnancies. Oral presentation at the biannual meeting for the International Society for Prenatal Diagnosis in Amsterdam, Netherlands, 2010.
Maternal–Fetal Medicine
ABSTRACT PRESENTATIONS (NATIONAL) Wenstrom K, Erickson K, Schulkin J. Are generalist Ob-Gyns satisfied with their MFM consultants? A survey. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Gyamfi, C, Blumenfeld Y, Ramsey P, Foley M, Kilpatrick S, Wenstrom K. The current state of MFM fellowships: results from the SMFM fellow survey. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, 2010. Anderson BL, Hillier SL, Raker C, Fitzsimmons C, Cu-Uvin S. Maternal inflammatory mediators are increased as early as the first trimester in low risk pregnancies. Poster presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, February, 2010, Chicago, IL. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S231. Johnson JM, Anderson BL. Mersilene Versus Ethibond Suture Efficacy and Cerclage. Poster presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, February, 2010, Chicago, IL. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S244. Johnson JM, Anderson BL, Raker C, Wenstrom KD. Timing of delivery with placenta previa: maternal and neonatal outcomes. Poster presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, February, 2010, Chicago, IL. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S74. Johnson JM, Anderson BL, Raker C, Wenstrom KD. Elective Inductions at Term and Adverse Neonatal Outcomes. Poster presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, February, 2010, Chicago, IL. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S124-5. Anderson BL, Wira CR, Fitzsimmons C, Ghosh M, Fahey J, Cu-Uvin S. Cervicovaginal fluid from pregnant and non-pregnant women suppresses HIV infectivity in an in vitro model. Oral presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, February, 2010, Chicago, IL. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S43. Matteson KA, McMahon M, Sung VW, Anderson BL, Raker CA, Phipps MG. Development and evaluation of a formal research curriculum for obstetrics and gynecology residents. Poster presentation at the 2010 APGO CREOG Annual Meeting, March, 2010, Orlando, FL. Anderson BL for the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Maternal Fetal Medicine Units Network. The impact of antibiotic therapy on vaginal flora among women with a positive fetal fibronectin. Poster presentation at the 57th Annual Meeting of the Society for Gynecologic Investigation, March, 2010, Orlando, FL. McDonnold MA, Friedman A, Raker C, Anderson B. Morbidity Associated with Postpartum Pyelonephritis as Compared to an Antepartum Population. Poster presentation for the 58th annual clinical meeting of the American Congress of Obstetricians and Gynecologists, May, 2010, San Francisco, CA. Anderson BL, Rouse DJ, Fitzsimmons C. Clinical Characteristics of Pregnant Women with 2009 H1N1 Influenza. Poster presentation at the 37th Annual Meeting for the Infectious Disease Society for Obstetrics and Gynecology, Santa Fe, NM, August, 2010. 64
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Anderson BL, Firnhaber C, Liu T, Swarts A, Siminaya M, Cu-Uvin S. Self-Collected Vaginal Swabs for Trichomoniasis Testing in HIV-infected Women in South Africa. Poster presentation at the 37th Annual Meeting for the Infectious Disease Society for Obstetrics and Gynecology, Santa Fe, NM, August, 2010.
Critchfield A, Ji H, Long V, Chien EK. Changes in cervical elastin concentration in the pregnant rat. Society for Maternal Fetal Medicine Annual Meeting 2010. Chicago, IL. Am J Obstet Gynecol 201:S74-75:2010. Johnson J, Long V, Ji H, Chien EK. Strain induces collagen production by cervical stromal cells. Society for Maternal Fetal Medicine Annual Meeting 2010. Chicago, IL. Am J Obstet Gynecol 201:S84:2010. Ji H, Long V, Chien EK. Mechanical stretch modulates extracellular matrix remodeling and MAP kinase pathway activation in rat cervical stromal cells. Society for Gynecologic Investigation Annual Meeting, Orlando, FL. March 2010. Reprod Sciences 17(3):74A, 2010. Ji H, Briody V, Noh J-H, Chien EK. Integrin α2 is modulated by stretch in rat cervical stromal cells. Society for Maternal Fetal Medicine Annual Meeting 2011, San Francisco, CA. (Accepted) Yogev Y, Chen R, Hod M, Coustan D, Oats JJN, Metzger B, Lowe L, Dyer AR, Trimble, Hadden D, Persson B for the HAPO Study Cooperative Research Group: Associations with preeclampsia: lessons from the hyperglycemia and adverse pregnancy outcome (HAPO) study. Society for Maternal-Fetal Medicine 30th Annual Meeting, Chicago, February 2010. Johnson J. Mersilene versus Ethibond suture efficacy and cerclage. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Johnson J, Anderson B, Raker C, Wenstrom K. Elective inductions at term and adverse neonatal outcomes. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Johnson J, Anderson B, Raker C, Wenstrom K. Timing of delivery with placenta previa: maternal and neonatal outcomes. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Johnson J, Long V, Ji H, Chien E. Strain induces collagen production by cervical stromal cells. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Sprawka N, Timmins, A, Sangi-Haghpeykar, H, Mathieson, K, Coonrod, D. Troponin I Levels in Mild and Severe Preeclampsia. Annual meeting for the Society of Maternal Fetal Medicine in San Diego, CA, 2009 Kassis N, Heard A, Sprawka N, Cu-Uvin S, Anderson B. Antiretroviral Induced Hepatotoxicity Presenting as Non-Reassuring Fetal Testing. Annual meeting for Infectious Diseases Society for Obstetrics and Gynecology Montreal, QC 2009 Sprawka N, Lambert-Messerlian G, Palomaki G, Canick J. The Effect of Oral Hypoglycemic Agents on Maternal Serum Alpha-Fetoprotein Levels in Diabetic Pregnancies. Annual meeting for the Society of Maternal Fetal Medicine in Chicago, IL, 2010.
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Anderson BL, Wira CR, Fitzsimmons C, Ghosh M, Fahey J, Cu-Uvin S. Cervicovaginal Fluid from Third Trimester Pregnant and Non-Pregnant Women Suppresses HIV Infectivity in an In Vitro Model. Poster presentation at the 37th Annual Meeting for the Infectious Disease Society for Obstetrics and Gynecology, Santa Fe, NM, August, 2010
CLERKSHIP PROGRAM B. Star Hampton, MD, Clerkship Director Dr. Hampton, Assistant Professor of Obstetrics and Gynecology and a member of the Division of Urogynecology and Reconstructive Pelvic Surgery, continues her role as Director of the Obstetrics and Gynecology Core Clerkship for the Alpert
Medical Education
MEDICAL EDUCATION
School of Medicine of Brown University. Barbara M. O’Brien, MD, Associate Clerkship Director Dr. O’Brien, Assistant Professor of Obstetrics and Gynecology and a member of the Division of Maternal Fetal Medicine, continues her active role as the Associate Director. The core clerkship continues to flourish, as evidenced by improved overall evaluations of the clerkship as well as an increase in numbers of students interested in pursing Ob/Gyn residencies. The 2009 match saw eight Alpert Medical Students successfully pursue Ob/Gyn residencies, and the coming year has even more interested. This year students began to be assigned time on Maternal Fetal Medicine, rotating with that service for two mornings during their time on labor and delivery. This afforded students exposure to patients with high-risk pregnancies, and allowed students to be part of the team for a short time. Students felt this was a valuable addition to their learning experience, and stated they only wished they had more time with the team. Students continue to be taught according to APGO medical student learning objectives. Existing lecture content is continuously reviewed and revised based on these learning objectives as well as student feedback. Students are encouraged to utilize resources provided by APGO such as uWise shelf exam review questions, which are recognized with favorable comments. Outpatient community based faculty preceptorships continue to provide students with additional outpatient experience and exposure to physicians in the community. Students spend one half day session in their preceptor’s office, gaining valuable exposure to the “daily life” of a community-based faculty member. Comments from both students and physicians alike are very favorable. The RIME method to classify students into one of four categories, namely Reporter, Interpreter, Manager, and Educator is still utilized for mid-clerkship review of each student. The clerkship directors meet with each student at mid-clerkship to review individual comments and classification, as well as student self assessment and goals. In addition, a “patient passport” is used in an effort to review student clinical exposure and experience. Review of students’ clinical
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experience reveals excellent scope and breadth. Dr. Hampton and Dr. O’Brien also meet with students at the end of each clerkship to discuss how to improve the experience, and changes are made according to student suggestions. Outstanding resident and faculty involvement in student teaching continues to be encouraged and facilitated. Directors meet with residents during resident business meetings to address any student concerns or changes. Residents continue to have an important role in medical student orientation, with residents reviewing ward expectations, scrubbing, gowning and gloving, instrument recognition, and knot tying. Quality of teaching scores continue to increase as rated
Students have the option to participate in Dr. Pablo Rodriguez’ Latino radio show, “Nuestro Salud.” This unique experience allows students the opportunity to present a case they have prepared for their classmates and explain it to a lay, Latino population. This enables the students to improve not only their communication skills but also their health literacy skills. The student interest group is also active on the Brown campus. Activities throughout the year include “Deliver a Baby Week” as well as application and interview primers for students interested in Ob/Gyn.
OB/GYN RESIDENCY PROGRAM Gary Frishman, MD continues in his role as both the Residency Program Director and the Associate Division Director in the Division of Reproductive Endocrinology and Infertility. Roxanne Vrees, MD is the Associate Residency Program Director and continues her work in Triage. Eight residents graduated from the program with six entering fellowship programs (two at Women & Infants), one entering private practice and one entering the Indian Health Service on the Navajo Nation reservation. In 2010, four hundred sixty-four candidates applied to the Brown Ob/Gyn Residency Program. We interviewed eighty to fill the eight intern positions for the 2010-2011 academic year. The total number of residents in the four-year program is 32. We have increased our formalized didactic experiences with scheduled talks every day on rounds with both the obstetric and gynecologic services. A new Pediatric Outcomes multi-disciplinary conference has been added to the noon conference schedule. The new PGY 1 residents receive special dedicated lecture topics in the fall geared towards their needs and level of training. The program has moved to a new web-based recording system for resident duty hours. We are implementing new educational formats including a posted question on the labor floor (continued)
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by the students at the end of the clerkship.
for medical students, residents, and nursing staff to respond to as well as a fetal monitor strip review for obstetric rounds. We have two new rotations having added a new “swing shift” block with last year’s third-year class to facilitate residents’ ability to leave the hospital and stay within duty hours on busy services as well as, with this year, a new “float” rotation in the fourth year class which provides them the opportunity and ability to rotate in areas in which they feel that they have specific interest or feel the need for additional exposure to (examples include the wound clinic at Kent Hospital, hav-
Medical Education
ing a session at the Women’s Day Hospital, additional ultrasound exposure at the PDC, etc.). Under the direction of Dr. Pagidas, we have implemented a new ultrasound curriculum integrating Maternal Fetal Medicine, Triage, Reproductive Endocrinology, etc.) with the ultimate goal of having residents being able to apply for AIUM certification upon graduation. In addition to the annual dinner held for the PGY 2 class with the Fellowship Directors (at which time informal discussions are held about the subspecialties and fellowships), we have added a dinner with Generalist Faculty to offer complementary information about going into Private Practice. We had our second annual “mini-boot camp” given by our residents for the graduating Brown Medical Students going into Ob/Gyn at any Residency Program around the country. This provides our students with a jump start prior to starting internship. Topics reviewed include writing orders, performing an endometrial biopsy, rupturing membranes and placing a scalp clip, etc.
SAPHIER FAMILY LECTURE IN OBSTETRICS AND GYNECOLOGY Established in 2007 by Carl J. Saphier ‘88 MD’92 to support an annual lecture focused on issues related to Women’s Health, including Maternal Fetal Medicine, Reproductive Endocrinology and Fertility, Urogynecology, and Women’s Oncology. Brown and the World: Engaging HIV-Infected Women Susan Cu-Uvin, MD The Miriam Hospital, Providence, RI Director, Global Health Initiative, Brown University Professor, Ob/Gyn and Medicine, The Warren Alpert Medical School of Brown University 8:30 a.m.
Research Paper Presentations
Ob/Gyn Residents and Fellows
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RESIDENT/FELLOW RESEARCH DAY Guest Judge: Susan Cu-Uvin, MD The Miriam Hospital, Providence, RI
Director, Global Health Initiative, Brown University
Professor, Ob/Gyn and Medicine, The Warren Alpert Medical School of
Brown University
Judges:
Joanna M. Cain, MD, Obstetrician and Gynecologist-in-Chief
Gary N. Frishman, MD, Residency Program Director
Moderator:
Kristen A. Matteson, MD, MPH
Presenting Residents Karen L. Archabald, MD, Resident in Obstetrics and Gynecology: Anemia and chorioamnionitis at term Julie A. Baker, MD, PhD, Resident in Obstetrics and Gynecology: Association between maternal-fetal attachment and quitting smoking with pregnancy recognition Molly S. Carey, MD, Resident in Obstetrics and Gynecology: An observational study of pain with IUD insertion Laura L. Holman, MD, Resident in Obstetrics and Gynecology: A comparison of sentinel lymph node identification between lymphoscintigraphy and sentinel lymph node dissection in patients with vulvar cancer Amanda L. Jackson, MD, Resident in Obstetrics and Gynecology: A novel biomarker for the management of patients with epithelial ovarian cancer Nadine Kassis, MD, Resident in Obstetrics and Gynecology: Effect of surgical therapy on improving physical activity levels in women with stress urinary incontinence Mollie A. McDonnold, MD, Resident in Obstetrics and Gynecology: Neurologic outcomes associated with polyhydramnios Megan D. McMahon, MD, Resident in Obstetrics and Gynecology: The effect of obesity on perioperative outcomes of laparoscopic hysterectomy Presenting Fellows Sonali Pandya, MD, Fellow in Breast Health: Should we excise all breast core-biopsy proven papillary lesions? Ashley Stuckey, MD, Fellow in Gynecologic Oncology: Developing an integrated genomic approach to explore the antitumor activity of vitamin D and derivatives to treat ovarian cancer Julie M. Johnson, MD, Fellow in Maternal Fetal Medicine: Mersilene versus Ethibond suture efficacy and cerclage Kyle J. Wohlrab, MD, Fellow in Urogynecology: The association between regional anesthesia and acute postoperative urinary retention in women undergoing outpatient midurethral slings. (continued)
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FACULTY AND RESIDENT AWARDS UNDERGRADUATE MEDICAL EDUCATION TEACHING AWARDS APGO Excellence-in-Teaching Award Christina Bandera, MD Top Community-based Faculty Teacher of the Year Awards Kathleen Bowling, MD
Medical Education
Frank Pensa, MD Pablo Rodriguez, MD Meera Simoes, MD Jackie Tetreault, MD Top Hospital-based Faculty Teacher of the Year Awards Amy Gottlieb, MD Michael Paglia, MD Maureen Phipps, MD Charles Rardin, MD Vivian Sung, MD Top Fellow Teacher of the Year Award Kyle Wohlrab, MD Top Resident Teacher of the Year Award Megan McMahon, MD Top Specialty Nursing Faculty Teacher of the Year Award Ann Holdredge, CNM, NP Top Community-based Faculty Excellence-in-Teaching Awards Dave Beitle, MD
Tolga Kokturk, MD
Jennifer Boyle, MD
Frank Pensa, MD
Kathleen Bowling, MD
Pablo Rodriguez, MD
Paula DeYoung, MD
Meera Simoes, MD
Michele Gange, MD
Jackie Tetreault, MD
Fred Hawwa, MD
Marguerite Vigliani, MD
Hospital-based Faculty Excellence-in-Teaching Awards Rebecca Allen, MD
Paul DiSilvestro, MD
Kristen Matteson, MD
Vivian Sung, MD
Christina Bandera, MD
Sarah Fox, MD
Barbara O’Brien, MD
Trevor Tejada Berges, MD
Andrew Blazar, MD
Gary Frishman, MD
Michael Paglia, MD
Cassandra Carberry, MD Amy Gottlieb, MD
Maureen Phipps, MD
Steve Carr, MD
Star Hampton, MD
Charles Rardin, MD
Donald Coustan, MD
Donna LaFontaine, MD
Pablo Rodriguez, MD
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Excellence-in-Teaching Awards
Catherine Albright, MD
Diane Angelini, EdD, CNM
Karen Archibald, MD
Anne Cooper, RNP
Elizabeth Cappelletti, MD
Paulette Corey, RNP
Molly Carey, MD
Erin Dobson, RNP
Beth Cronin, MD
Elisabeth Howard, PhD, CNM
Luu Doan, MD
Linda Hunter, EdD, CNM
Terri Febbraro, MD
Edie McConaughey, CNM
Amanda Jackson, MD
Linda Moulton, RNP
Jennifer Kang, MD
Patricia O’Connell , RNP
Nadine Kassis, MD
Janet Singer, MSN, CNM
Mollie McDonnold, MD
Linda Steinhardt, MS, FNP-C, CNM
Megan McCoin, MD
Anne Stulik, RNP
Katherine Melzer, MD
Medical Education
Specialty Nursing Faculty
Jeannine Miranne, MD Kavita Mishra, MD Katina Mori, MD Michaela Onstad, MD Pablo Orezzoli, MD Dario Roque, MD
RESIDENT MEDICAL EDUCATION TEACHING AWARDS CREOG Excellence-in-Teaching Award Donald R. Coustan, MD Top Community-based Faculty Teacher of the Year Awards Terrence Cahill, MD Rebecca Crichton, MD Kathryn Davis, MD Cynthia Hanna, MD Tawfik Hawwa, MD Top Hospital-based Faculty Teacher of the Year Awards Donald Coustan, MD Robyn Gray, DO Kristen Matteson, MD Barbara O’Brien, MD Charles Rardin, MD
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Top Fellow Teacher of the Year Awards Kyle Wohlrab, MD Wendy Vitek, MD Top Specialty Nursing Faculty Teacher of the Year Awards Elisabeth Howard, CNM
Medical Education
Edie McConaughey, CNM Community-based Faculty Excellence-in-Teaching Awards David Beitle, MD
Stephen Falkenberry, MD
Kathleen Bowling, MD
Alfredo Gil, MD
Christine Brousseau, MD
Cynthia Hanna, MD
Terrence Cahill, MD
Tawfik Hawwa, MD
Wayne Clairborne, MD
Janet Lefkowitz, MD
Jeannine Connolly, MD
Carol Manning, MD
Rebecca Crichton, MD
Carol Medeiros, MD
Kathryn Davis, MD
Frank Pensa, MD
Joseph DeMartino, MD
Marilyn Powers, MD
Beata DiZoglio, MD
Gary Wharton, MD
Hospital-based Faculty Excellence-in-Teaching Awards Brenna Anderson, MD
Deborah Myers, MD
Bala Bhagavath, MD
Barbara O’Brien, MD
Andrew Blazar, MD
Kelly Pagidas, MD
Joanna Cain, MD
Maureen Phipps, MD
Donald Coustan, MD
Charles Rardin, MD
Gary Frishman, MD
Moune Jabre Raughley, MD
Robyn Gray, DO
Vivian Sung, MD
B. Star Hampton, MD
Trevor Tejada-Berges, MD
Donna LaFontaine, MD
Roxanne Vrees, MD
Kristen Matteson, MD
Katharine Wenstrom, MD
Fellow Excellence-in-
Specialty Nursing Faculty Excellence-in-
Teaching Awards
Teaching Awards
Nada Kawar, MD
Diane Angelini, EdD, CNM
Peter Klatsky, MD
Elisabeth Howard, PhD, CNM
Katrin Kristjansdottir, MD
Linda Hunter, EdD, CNM
Blair Washington, MD
Edie McConaughey, CNM
Kyle Wohlrab, MD
Janet Singer, CNM
Wendy Vitek, MD
Linda Steinhardt, MS, FNP-C, CNM
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RESIDENT AWARDS FROM FACULTY David H. Nichols Award for Excellence in Pelvic Surgery Beth Cronin, MD Excellence in Resident Research Award Mollie McDonnold, MD The Outstanding Resident Award for Professionalism and Humanism in Women’s Health Megan McMahon, MD
Medical Education
Chief Administrative Resident Awards Beth Cronin, MD and Laura Richio, MD AAGL Special Resident in Minimally Invasive Gynecology Nicole Korbly, MD SLS Outstanding Laparoendoscopic Resident Surgeon Nadine Kassis, MD
AWARDS FROM CHIEF RESIDENTS The “Life Saver” Award
Special Recognition Awards
Robyn Gray, DO
Wendy Bergren, RN
Mentorship Award
Cynthia DiBlasi, RN Dita Lubera, RN
Kathleen Bowling, MD Community-based Faculty Awards Terrence Cahill, MD
Barbara McCaffrey Karen Newberg Noemia Norberg, RN
Beata DiZoglio, MD
Sue Pirri
Lisa Domagalski, MD
Ana Santos
Tawfik Hawwa, MD
Chrystal Smith
Carol Manning, MD
Pat Vest
Gary Wharton, MD Hospital-based Faculty Awards Bala Bhagavath, MD
Fellow of Excellence Award Kyle Wohlrab, MD
Paul DiSilvestro, MD Star Hampton, MD Kristen Matteson, MD Barbara O’Brien, MD Maureen Phipps, MD
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DIVISION OF REPRODUCTIVE ENDROCRINOLOGY AND INFERTILITY MISSION: CARING, SHARING, QUERYING Caring for patients during their reproductive lifespan, sharing educational aspects to students of reproduction, and querying through research aspects of reproductive medicine embodies the mission of the Division of Reproductive Endocrinology and Infertility. The Center for Reproduction and Infertility is the clinical service of the division encompassing patients with problems involving endocrinology of the reproductive system, lactation, and pregnancy; infertility,
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in vitro fertilization [IVF], and surgical repair to restore reproductive function; reproductive anomalies; the menopause; pediatric gynecology, and disorders of puberty, ovulatory function, hirsutism, and galactorrhea.
FACULTY Sandra Ann Carson, MD, Division Director MD: Northwestern University Residency: Prentice Women’s Hospital, Northwestern University Fellowship: University of Chicago Dr. Carson joined the division in 2007 as its director and a Professor of Obstetrics and Gynecology. She came from Baylor College of Medicine where she directed the Programs in Advanced Reproduction. Her research in ectopic pregnancy, unexplained infertility and polycystic ovarian disease has been supported for over 15 years by the National Institutes of Health. She has served as President of the American Society of Reproductive Medicine, Vice President of the American College of Obstetricians and Gynecologists and Secretary-Treasurer of the Society of Gynecologic Investigation. Currently she is Editor-in-Chief of Sexuality, Reproduction and Menopause. She is an Associate Editor of The American Journal of Obstetrics and Gynecology. She is the Vice President of the American Board of Obstetrics and Gynecology and is the Chairman of the Reproductive Endocrinology and Infertility subspecialty division of the Board. Dr. Carson was appointed as Chair of the Reproductive Health Drugs Advisory Committee of the Food and Drug Administration. She has served as a consultant to both the FDA’s Center for Devices and Radiological Health and the President’s Council on Bioethics. She is co-chairman of the Committee to Protect Women Who Serve as Oocyte Donors for Stem Cell Research of the California Institute of Regenerative Medicine.
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Gary Frishman, MD, Associate Division Director MD: Columbia University Residency: Pennsylvania Hospital Fellowship: University of Connecticut
Dr. Frishman joined the division in 1991 as Assistant Professor and is now a full Professor. He is Associate Division Director. Dr. Frishman also serves as Residency Program Director for the Obstetrics and Gynecology Residency at Women & Infants Hospital of Rhode Island/Brown University. He is board certified in Ob/Gyn and in Reproductive Endocrinology and Infertility and is a Board Examiner for the American Board of Obstetrics and Gynecology. Dr. Frishman has a major interest and focus on teaching, having won multiple Brown University and NaMedical School including writing the Dean’s letter for medical students applying for an Ob/Gyn residency and running the second year PathoPhysiology course. He currently lectures at both the graduate and undergraduate level. He created and runs two unique LISTSERVs. AcadObGyn is a nationwide LISTSERV, with over 800 subscribers, which addresses issues in resident and medical student education. AAGL-Endo-Issues, with over 3650 international members from over 25 countries, is devoted to topics related to Minimally Invasive Gynecologic Minimally Invasive Surgery. Dr. Frishman is a Contributing Editor to The Journal of Minimally Invasive Gynecology and is on the International Editorial Board of The Obstetrician and Gynaecologist. He has served twice as Vice President for the New England Fertility Society. Dr. Frishman is currently Vice President of the Society for Reproductive Surgeons. John E. Buster, MD, Associate Division Director, Tufts Medical Center Assistant Fellowship Director MD: University of California, Los Angeles Residency: Harbor General Hospital, University of California, Los Angeles Fellowship: University of California, Los Angeles Dr. Buster joined the Division in 2007 as Professor of Obstetrics and Gynecology. He practices principally at the Women and Infants’ Center for Reproduction and Infertility site at the Tufts Medical Center in Boston. After 30 years as an REI Division Director, Dr. Buster has proven wellsuited for administrative duties in the Fellowship program. Dr. Buster is best known for having led the team of researchers that developed a process for recovering and transplanting embryos from female donors to recipients that led to the first donated embryo human pregnancies and births in 1984. More uncommon knowledge is that he developed the first direct radioimmunoassay for DHEA-S and uncongugated estriol in pregnancy plasma. He was also among the first to describe, to exploit, and to publish extensively on the use of methotrexate for medical treatment of ectopic pregnancy. More recently, Dr. Buster conducted studies and published extensively on the use of transdermal testosterone to treat women with hypoactive sexual desire disorder, an approach with wide acceptance and in use throughout Europe and gaining (continued)
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tional (APGO and CREOG) teaching awards. He has held numerous leadership roles at Brown
acceptance in the United States. Most recently, Dr. Buster served as lead investigator and first author in the pivotal paper describing the first experience with an estradiol spray that delivers low doses of estrogen for effective treatment of vasomotor symptoms in post menopausal women. This spray was approved by the FDA in 2007, was launched in 2008, and is currently in use throughout the United States where it is known as Evamist®. Balasubramanian Bhagavath, MD Team Leader: Director of Endoscopic Training and Credentialing; Associate Director of Third Party Reproduction MD: Madras Medical College Residency: Medical College of Georgia, Georgia
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Fellowship: University of Texas Southwestern Medical Center Dr. Bhagavath joined the division in 2007 as Clinical Assistant Professor of Obstetrics and Gynecology after completing his fellowship in Texas. He is at present the only REI surgeon in the Rhode Island region (Rhode Island/southeastern Massachusetts/Eastern Connecticut) who performs robot-assisted surgeries. He is actively involved in student and resident education. He is the Course Director for OBG-494, an elective in Reproductive Endocrinology for fourth year medical students. He has been named an APGO Educational Scholar for 2010 and currently directs the APGO LISTSERV. As Director of Endoscopic Training and Credentialing, he runs the bi-annual endoscopy training course for the OB/Gyn residents. Dr. Bhagavath is a leader in the efforts to build a Simulation Center at WIH. His clinical and research interests include anomalies of the reproductive tract, premature ovarian failure, fertility preservation and egg donation. Andrew Blazar, MD Team Leader: Clinical Outreach MD: Tufts University School of Medicine Residency: Pennsylvania Hospital, University of Pennsylvania Fellowship: Karolinska Hospital in Stockholm, Sweden Dr. Blazar joined the division in 1994 after 30 years in clinical practice. He was the first director of the Infertility Clinic at Women & Infants Hospital of Rhode Island. Dr. Blazar’s research focuses on factors affecting IVF outcomes, particularly as related to hormone response and hydrosalpinx. His teaching responsibilities include directing an elective course in “Women’s Health Issues.” He directs the divisional clinical outreach efforts and oversees feasibility of satellite activities and is a Clinical Associate Professor of Obstetrics and Gynecology.
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Kelly Pagidas, MD Team Leader: Director of Preimplantation Genetic Diagnosis MD: McGill University School of Medicine Residency: McGill University, Montreal, Canada Fellowship: McGill University Dr. Pagidas joined the division in 1998. Her research interests include ovarian physiology, IVF outcomes, recurrent pregnancy loss, reproductive genetics and mechanisms underlying aneuploidy in embryos. She directs the longitudinal course for 2nd year Brown medical students. Dr. Pagidas founded and directs the program in Preimplantation Genetic Diagnosis (PGD) and is the Medical Director of Preimplantation Genetic Diagnosis both at Women and Infants and Tufts Medical Center. Dr. Pagidas is an examiner for the endocrinology oral certification examination.
Beth Plante, MD MD: University of Massachusetts Medical School Residency: Women & Infants Hospital of Rhode Island, Brown University Medical School Fellowship: University of North Carolina Dr. Plante joined the division in 2010 as a Clinical Assistant Professor of Obstetrics and Gynecology after completing a fellowship at the University of North Carolina. She is an avid clinician and educator at the Division’s sites in Massachusetts as well as Providence. She is investigating alterations in bio-markers during the menstrual cycle. Jared Robins, MD Team Leader: In Vitro Oocyte Maturation MD: State University of New York at Stony Brook Residency: Albert Einstein College of Medicine Fellowship: University of Cincinnati Dr. Robins joined the division in 2007 as an Assistant Professor of Obstetrics and Gynecology after a 5-year tenure as a Women’s Reproductive Health Research scholar at the University of Cincinnati. Dr. Robins leads the In Vitro Maturation (IVM) Program and the international training program in IVM which has trained physicians in this country and also from Asia and Europe. He was elected to the Society for Gynecological Investigation in 2010. His investigation is focused on the effect of hypoxia on trophoblast interaction and differentiation prior to implantation. In addition, he directs the clinical program in in vitro maturation of oocytes and oocyte cryopreservation for women choosing to preserve their fertility.
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She is an Assistant Professor of Obstetrics and Gynecology at Brown and Tufts University.
Carol Wheeler, MD Team Leader: Third Party Reproduction, Pediatric/Adolescent Gynecology Clinic MD: Jefferson Medical College. Residency: Wright State University, Dayton, Ohio Fellowship: University of Pennsylvania Dr. Wheeler joined the division in 1990 from the faculty at Tulane University, New Orleans, Louisiana. After being in private practice for four years, she rejoined the division faculty in 2006. Dr. Wheeler is a Clinical Associate Professor of Obstetrics and Gynecology. She founded the division’s third party reproduction program and is actively involved in student and resident education serving as the director of the resident rotation in reproductive endocrinology. Her research interests include menopause in different ethnic groups and she was a co
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investigator on the Women’s Health Initiative, the largest study of menopause in the United States. She chairs the Bioethics committee at Women & Infants Hospital of Rhode Island. She developed and directs the pediatric/adolescent gynecology clinic in the WPCC. She leads the ASRM mentoring program for the Women’s Council. She serves on the Editorial Board of Sexuality, Reproduction and Menopause. Jeannine Witmyer, PhD, HCLD(ABB) IVF Laboratory Director. PhD: Boston College Dr. Witmyer is a Clinical Assistant Professor of Obstetrics and Gynecology as well as the Laboratory Director of the In Vitro Maturation Training Program. She joined the division in 2007 as IVF Laboratory Director of the embryology labs at both Tufts Medical Center and Women & Infants Hospital of Rhode Island after a 21-year tenure as a Laboratory Supervisor at Boston IVF. She has worked in the field of clinical embryology since 1980 and was part of the clinical team responsible for the first IVF birth in Norfolk, VA. She was a member of the Harvard research team deriving 17 new human embryonic stem cell lines in 2004. Her research interests include sperm nuclear proteins, embryo morphology, oocyte/embryo culture, and oocyte cryopreservation.
CARING: WOMEN AND INFANTS’ CENTER FOR REPRODUCTION AND INFERTILITY The Center for Reproduction and Infertility is the clinical arm of the division which includes the in vitro fertilization program, oocyte donation, gestational surrogacy, intracytoplasmic sperm injection, fertility cryopreservation, preimplantation genetic diagnosis and management of patients referred to the division with reproductive health problems. The division is well known to partner with patients’ obstetrician-gynecologists from the local community and the nation to provide state-of-the art clinical care in problems requiring subspecialty expertise. The Center recently moved to 90 Plain Street in Providence where patient consultations and IVF–related procedures are performed. The new Center was designed specifically for the reproductive medicine program, highlighting intimacy in couples’ care. In addition, the Tufts Medical Center serves as a northern branch of the Center. 78
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Satellite offices of the Center for Reproduction and Infertility span three states. The Center offers monitoring and patient consultation in Woonsocket, East Greenwich, and South Kingstown, Rhode Island; Fall River, Foxboro, Melrose, and Swansea, Massachusetts, and in Putnam, Connecticut.
SHARING: EDUCATIONAL FUNCTIONS The Educational program of the Division of Reproductive Endocrinology and Infertility at Women & Infants Hospital of Rhode Island spans geography and chronology. In 2000, the division developed an affiliation with the Division of Reproductive Endocrinology at Tufts Medical School, in Boston, Massachusetts. The combined Divisions now provide a regional network of clinical year medical students, the Division participates in Biomed 351 Integrated Pathophysiology and Pharmacology course at Alpert Medical School, Brown University. At both Brown and Tufts, the division teaches the third and fourth year medical students in the Obstetrics and Gynecology core clerkship (Biomed 331A); and Brown fourth year students through our 4th year electives in Reproductive Medicine (Biomed 342A) and Reproductive Health (Biomed 496). Division faculty serve as preceptors for Brown medical students and residents. All physicians in the Division teach medical students and residents, while caring for patients during office hours and in the operating room. Dr. Frishman directs the residency in obstetrics and gynecology. The faculty consistently are highly rated preceptors and lecturers. Peter Klatsky, MD, MPH MD: The Mount Sinai School of Medicine—New York, New York MPH: Columbia University—New York, NY Residency: University of California, San Francisco Dr. Klatsky joined the division in July 2008 as a clinical and research fellow. He is currently investigating novel, minimally-invasive approaches to evaluate genetic expression in developing oocytes and embryos. His clinical research interests include fibroids, predictors of success and long term safety outcomes in women using assisted reproduction technologies. During residency, he received honors for his endoscopic surgical skills as well as his clinical research on the effect of fibroids on reproductive outcomes. He enjoys clinical teaching and mentoring residents at a community reproductive endocrinology clinic. In his spare time, he provides volunteer care to women at the Rhode Island Free Clinic. Wendy Vitek, MD MD: University of Rochester School of Medicine & Dentistry Residency: Magee-Womens Hospital, University of Pittsburgh Medical Center Dr. Vitek joined the Division in July 2009 as a clinical and research fellow. Her research interests include folliculogenesis, tissue engineering and fertility preservation. She enjoys teaching medical students and residents and has received teaching awards during residency and fellowship.
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care and education in Reproductive Medicine across New England. Beginning with second
QUERYING: RESEARCH IN REPRODUCTIVE MEDICINE The division’s research endeavors have long focused around in vitro fertilization, its outcome measures and pre-implantation genetic diagnosis. The addition of Drs. Carson, Buster and Robins have broadened the research focus to include trophoblast culture, oocyte maturation, fertility cryopreservation and the effect of reproductive toxicants on oocyte development. Programs to initiate clinical research using recombinant growth factors in the stimulation of ovarian follicles have begun. New indications for drugs in ovation induction offer patients op-
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portunities to participate in protocols which may enhance otherwise dismal chances of pregnancy. The division’s efforts to stimulate oocyte development in women who have been turned away from other programs offer patients with “terminal infertility” a chance to be a parent while simultaneously contributing to the forefront of our knowledge of ovarian function. Partnerships with basic scientists at the Alpert Medical School have been developed in an effort to create a three-dimensional ovarian culture system. This system will explore all aspects of oocyte development and the effect of reproductive toxicants. This knowledge will be extended to environmental toxins and issues involved in oocyte cryopreservation as well as issues in standard oocyte culture at the time of in vitro fertilization
HIGHLIGHTS CARING •
The Division moved to new offices designed specifically for the reproductive endocrinology
patient needs.
•
One clinical satellite was added to the division’s clinical outreach network:
Fall River, Massachusetts.
•
Drs. Buster, Carson and Robins were named to the list of Best Doctors in America.
SHARING •
Dr. Carson was appointed Vice President of the American Board of Obstetrics
and Gynecology.
•
Dr. Carson was appointed Chair of FDA Advisory Committee for Reproductive
Health Drugs.
•
Dr. Robins leads an international education program for in vitro maturation, hosting and
training physicians from Asia, Europe and the Middle East.
QUERYING • The Division was awarded a $1 million research contract to investigate a new drug for
in-vitro fertilization.
• Dr. Robins was awarded research funding through the Women & Infants Hospital of Rhode 80
Island COBRE grant by the NICHD. Depa r t m e n t
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PEER-REVIEWED PUBLICATIONS Carson SA, Wiggins D. Female Sexual Health and Its Dysfunction. Clinical OB/GYN (submitted 2009) Legro RS, Schlaff WD, Diamond MP, Coutifaris C, Casson PR, Brzyski RG, Christman GM, Trussell JC, Krawetz SA, Snyder PJ, Ohl D, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER, Santoro N, Eisenberg E, Zhang M, Zhang H. Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism. J Clin Endocrinol Metab (submitted May 2010) Klatsky PC, Carson SA, Wessel GM. Detection of oocyte mRNA in starfish polar bodies. Mol Reprod Dev. 2010 May;77(5):386. Buster JE. Transdermal menopausal hormone therapy: delivery through skin changes the rules. Expert Opin. Pharmacother 2010 11(9):1-12.
Wessel GM, Reich A, Klatsky PC. Use of Sea Stars to Study Basic Reproductive Processes. Systems Bio in Reprod Med. In press 2010. Pagidas K, Carson SA, McGovern PG, Barnhart HX, Myers ER, Legro RS, Diamond MP, Carr BR, Schlaff WD, Coutifaris C, Steinkampf MP, Cataldo NA, Nestler JE, Gosman G, Giudice LC. Body mass index and intercourse compliance for the National Institute of Child Health and Human Development-Reproductive Medicine Network. Fertil Steril. 2009 Jun 19. Pagidas K, Carson SA, McGovern PG, Barnhart HX, Myers ER, Legro RS, Diamond MP, Carr BR, Schlaff WD, Coutifaris C, Steinkampf MP, Cataldo NA, Nestler JE, Gosman G, Giudice LC. Intercourse compliance, ovulation, and treatment success in the National Institute of Child Health and Human Development-Reproductive Medicine Network’s Pregnancy in Polycystic Ovary Syndrome (PPCOS) Trial. for the National Institute of Child Health and Human Development–Reproductive Medicine Network. Fertil Steril. 2009 Jun 19 Plante BJ, Kannan A, Bagchi MK, Yuan L, Young SL. Cyclic regulation of transcription factor C/ EBPβ in human endometrium. Reprod Biol Endocrinol 2009;7:15. Plante BJ, Cooper GS, Baird DD, Steiner AZ. The impact of smoking on antimullerian hormone levels in women ages 38-50 years. Menopause (in press). Plante BJ, Moldenhauer J, Landy C, Beamon C, Steiner AZ. Maternal Antimullerian Hormone and Fetal Aneuploidy. Journal of Assisted Reproduction and Genetics (in press). Erb TM, Vitek WS, Wakim, ANG. Gonadotropin-releasing hormone agonist or human chorionic gonadotropin for final oocyte maturation in an oocyte donor program. Fertil Steril 2010;93(2):374-8
BOOKS AND BOOK CHAPTERS Carson SA, Wiggins D (eds). Clinical Obstetrics and Gynecology: Sexuality and Sexual Dysfunction. Lippincott Williams & Wilkins, 2009. Krotz S, Carson SA. Ectopic Pregnancy. Biennial Review of Infertility, Chapter 5 (in press, 2009)
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Melzer K, Klatsky PC, Krotz S, Robins J, Carson SA. In Vitro Fertilization Protocols in Poor Responders: A comparison of outcomes in patients repeating the same protocol versus switching protocols. ASRM October 2009
INVITED PRESENTATIONS (LOCAL) Carson SA. “Unexplained Infertility,” RESOLVE of the Bay State, Providence, RI, June 15, 2009. Carson SA. “Moving Into the Future: New Dimensions and Strategies for Women’s Health Research,” Co-Chair, Working Group on Adolescent Health, Office of Women’s Health of the National Institutes of Health U.S. Department of Health and Human Services National Conference, Warren Alpert Medical School of Brown University/Women & Infants Hospital of Rhode Island, Providence, RI, September 21, 2009. Carson SA. “Sexual Issues and Reproductive Options, including Preimplantation Genetic Diagnosis (PGD),” Women & Infants Hospital of Rhode Island/American Cancer Society Symposium on Hereditary Breast and Ovarian Cancer, Providence, RI, September 26, 2009.
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Carson SA. “Making the Choice of Gonadotropins,” Beth Israel Deaconess/Boston IVF REI Lecture Series, Boston, MA, October 13, 2009. Carson SA. “An Update on Female Sexual Response,” Endocrine Grand Rounds, Rhode Island Hospital, Providence, RI, January 20, 2010. Carson SA. “An Update on Female Sexual Response,” Grand Rounds, Memorial Hospital of Rhode Island, Pawtucket, RI, January 21, 2010. Carson SA. “An Update on Female Sexual Response,” Pelvic Floor Disorders Conference, Women & Infants Hospital of Rhode Island, Providence, RI, March 13, 2010. Carson SA. “An Update on Female Sexual Dysfunction,” Grand Rounds, Massachusetts General Hospital, Boston MA, May 6, 2010. Carson SA. “Take Down the Heat of Hot Flashes,” Sisterhood meeting, Temple Sinai, Cranston RI, June 2, 2010.
INVITED PRESENTATIONS (NATIONAL) Carson SA. “REI Certification and Maintenance of Certification,” American Society of Reproductive Medicine Fellows Retreat, Park City, UT, August 2, 2009. Carson SA. “Update on Female Sexual Dysfunction,” Albert Einstein School of Medicine Grand Rounds, Bronx, NY, September 15, 2009. Carson SA. Clark L, Carson SA, Wheeler CA, Bhagavath B. Poster Presentation: Role Of Routine Monitoring Of Hepatic And Renal Function Prior To Methotrexate Treatment For Ectopic Pregnancy. American Society of Reproductive Medicine (ASRM) Annual Meeting, Atlanta, GA, October 17-21, 2009. Carson SA. “Helping Your Patients Avoid Obesity,” Grand Rounds, ChristianaCare Annual Resident Symposium, Newark, DE, March 24, 2010. Carson SA. “An Update on the Medical Treatment of Ectopic Pregnancy,” ChristianaCare Annual Resident Symposium, Newark, DE, March 24, 2010. Carson SA. “An Update on Female Sexual Dysfunction,” ChristianaCare Annual Resident Symposium, Newark, DE, March 24, 2010. Carson SA. “The Transformational Impact of the Pill Over 50 Years,” Panelist selected by Today’s Woman with Gloria Steinem and Jocelyn Elders, ACOG Annual Clinical Meeting, San Francisco CA, May 17, 2010. Carson SA. “Female Sexuality and Psychological Well-Being,” Post-Graduate Course, ACOG Annual Clinical Meeting, San Francisco CA, May 18, 2010.
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INVITED PRESENTATIONS (INTERNATIONAL) Carson SA. “Helping Your Patient Avoid Obesity,” 60th Mexican Congress of Gynecology and Obstetrics, Cancun, Mexico, November 3, 2009. Carson SA. “But Doctor, I Really Don’t Eat That Much,” 60th Mexican Congress of Gynecology and Obstetrics, Cancun, Mexico, November 3, 2009. Carson SA. “An Update on Female Sexual Dysfunction,” 60th Mexican Congress of Gynecology and Obstetrics, Cancun, Mexico, November 4, 2009. Carson SA. “Cryopreservation of Gametes and Ovaries,” 3rd Asian Pacific Congress on Controversies in Obstetrics, Gynecology & Infertility, Beijing, China, November 13, 2009.
Carson SA. “Hot Controversies: Expert Opinions on Controversial Topics,” Panel Discussions, 3rd Asian Pacific Congress on Controversies in Obstetrics, Gynecology & Infertility, Beijing, China, November 13, 2009.
ABSTRACT PRESENTATIONS (NATIONAL) Herbst S, Pauls R, Millheiser L, Carson SA, Parmer J, Willson C, Stern R, Chen B. Safety and efficacy of radiofrequency treatment for vaginal laxity-nonsurgical functional vaginal rejuvenation. 30th Annual Meeting, American Urogynecologic Society, Hollywood, FL, September 2009. Melzer KE, Klatsky PC, Krotz S, Carson SA, Robins JC. In vitro fertilization (IVF) protocols in poor responders: a comparison of patients remaining on the same stimulation. 65th Annual Meeting, American Society for Reproductive Medicine, Atlanta, GA, September 2009, Abstract #O-189. Krotz SP, Carson SA, Tomey C, Witmyer J, Buster JE. Environmental phthalates and bisphenol A do not preferentially accumulate in human follicular fluid. 65th Annual Meeting, American Society for Reproductive Medicine, Atlanta, GA, September 2009, Abstract #P-183. Klatsky PC, Witmyer J, Robins J, Wessel GM, Carson SA. Evidence of oocyte specific gene expression from polar body analysis. 65th Annual Meeting, American Society for Reproductive Medicine, Atlanta, GA, September 2009, Abstract #P-452. Clark L, Carson S, Wheeler C, Bhagavath B. Role of routine monitoring of hepatic and renal function prior to single-dose methotrexate treatment for ectopic pregnancy. Accepted for presentation at the 65th Annual Meeting of the American Society for Reproductive Medicine, November 2009, Atlanta, GA Blazar A. Poster presentation at ASRM 65th Annual Meeting.” Serum Anti Mullerian Hormone (AMH) Concentration Declines During IVF Cycles.” Atlanta, GA. October 2009. Blazar A. Oral presentation at ASRM 65th Annual Meeting. “Anti Mullerian Hormone (AMH) Levels at the Onset of IVF Predict Outcome Better Than Patient Age or Prior FSH Levels.” Atlanta, GA. October 2009 Klatsky PC, Witmyer J, Hackett R, Robins JC, Wessel G, Carson SA. Analysis of oocyte gene expression in polar bodies. ASRM October 2009. Klatsky PC, Witmyer J, Carson SA, Robins J. Routine Extended Culture Identifies Different Embryos for Freezing and Does Not Reduce Cryopreservation Rate. ASRM October 2009. Balthazar U, Plante BJ, Lessey BA, Wang W, Taylor RN, Bagchi MK, Young SL. “Secretory-phase regulation of human endometrial GPR30 expression.” Society of Gynecologic Investigation 57th Annual Meeting, Orlando, Florida, March 2010. (continued) Annual
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Carson SA. “Preservation of Fertility: Conservative Management of the Artificial Ovary,” Keynote Lectures (Women and Ovarian Cancer: From Conception to Diagnosis Capsule), 3rd Asian Pacific Congress on Controversies in Obstetrics, Gynecology & Infertility, Beijing, China, November 13, 2009.
Balthazar U, Plante BJ, Lessey BA, Young SL. “Elevated mid-secretory endometrial GPR30 expression in women with endometriosis.” Society of Gynecologic Investigation 57th Annual Meeting, Orlando, Florida, March 2010. Underhill LA, Shaw SK, Robins JC. Cellular growth parameters are altered when embryos are cultured under physiologic conditions. Presented at the Annual Meeting of the American Society for Reproductive Medicine, Atlanta, GA, 2009. (Oral Abstract). Melzer KE, Klatsky PC, S Krotz, Carson SA, Robins JC. In vitro fertilization (ivf) protocols in poor responders: a comparison of patients remaining on the same stimulation protocol with those that switched protocols. Presented at the Annual Meeting of the American Society for Reproductive Medicine, Atlanta, GA, 2009. (Oral Abstract).
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Robins JC, Krueger P, Underhill LA. Oxygen tension affects the proliferation and differentiation of trophoblast stem cells by altering the expression of the fibroblast growth factor receptor gene. Presented at the Annual Meeting of the American Society for Reproductive Medicine, Atlanta, GA. (Oral Abstract). Blazar AS, Krotz SP, Messerlian G, Hackett R, Robins JC. Anti mullerian hormone (amh) levels at the onset of ivf predict outcome better than patient age or prior fsh levels. Presented at the Annual Meeting of the American Society for Reproductive Medicine, Atlanta, GA, 2009. (Oral Abstract). Blazar AS, Krotz SP, Messerlian G, Hackett R, Robins JC. Anti mullerian hormone (amh) levels decline during ivf cycles. Presented at the Annual Meeting of the American Society for Reproductive Medicine, Atlanta, GA, 2009. (Poster) Underhill LA, Robins JC, Witmyer J, Pagidas K. The effect of oxygen tension pre and post preimplantation genetic diagnosis biopsy on embryo quality. Presented at the Annual Meeting of the American Society for Reproductive Medicine, Atlanta, GA, 2009. Clark L, Carson S, Wheeler C, Bhagavath B. Role of routine monitoring of hepatic and renal function prior to single-dose methotrexate treatment for ectopic pregnancy. Presented at the 65th Annual Meeting of the American Society for Reproductive Medicine, November 2009, Atlanta, GA. Krotz SP, Carson SA, Tomey J, Witmyer J, Buster JE. (2009) Environmental phthalates and bisphenol A do not preferentially accumulate in human follicular fluid. Poster Presentation at ASRM in Atlanta, GA, October 2009. Underhill LA, Robins JC, Witmyer J, Pagidas K. (2009) The effect of oxygen tension pre and post preimplantation genetic diagnosis biopsy on embryo quality. Poster Presentation at ASRM in Atlanta, GA, October 2009. Klatsky PC, Witmyer J, Robins JC, Wessel GM, Carson SA. (2009) Evidence of oocyte specific gene expression from polar body analysis. Poster Presentation at ASRM in Atlanta, GA, October 2009. Legro RS, Schlaff WD, Diamond MP, Coutifaris C, Casson PR, Brzyski RG, Christman GM, Trussell JC, Krawetz SA, Snyder PJ, Ohl D, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER, Santoro N, Eisenberg E, Zhang M, Zhang H. Total Testosterone Assays in Polycystic Ovary Syndrome: Is There a Gold Standard?. ENDO 2010, 92nd Annual Meeting & Expo, San Diego CA, June 19-22, Abstract #850038.
EDITORIALS Carson SA. Sexuality, Reproduction & Menopause, Editorials Respect Repairs Demoralization. Vol. 7, No. 3, August 2009 Relationship vs. Responsibility. Vol. 7, No. 4, October 2009 Are All Those Pins Really Necessary? Vol. 8, No. 1, February 2010
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DIVISION OF RESEARCH IN WOMEN’S HEALTH MISSION The mission of the Division of Research is to improve women’s health through developing innovative research and interdisciplinary collaborations as well as providing research support for diverse women’s health investigators. By providing expertise in research methodology, database management and statistical analysis, the division works towards the goal of developing new knowledge and transforming this knowledge into practical information that can be shared with health care providers and the community.
FACULTY Maureen G. Phipps, MD, MPH, Division Director and Vice-chair for Research BS: Boston College MPH: University of Michigan Residency: Women & Infants Hospital of Rhode Island Fellowship: Robert Wood Johnson Clinical Scholars Program, University of Michigan Dr. Maureen Phipps, Associate Professor of Obstetrics and Gynecology and Community Health at the Warren Alpert Medical School of Brown University, is the Vice-chair for Research and Division Director for the Research Division for the Department of Obstetrics and Gynecology. Dr. Phipps also directs the Brown University/ Women & Infants Hospital of Rhode Island National Center of Excellence in Women’s Health. Dr. Phipps joined the Department of Obstetrics and Gynecology in 2001 and has served as Division Director since 2007. Her research and academic activities involve collaborations across departments, hospitals and state agencies. Dr. Phipps is the principal investigator for several on-going interdisciplinary research projects and collaborates with investigators locally and nationally. She is an affiliate member of the Brown University Institute for Community Health Promotion and the Center for AIDS Research. Dr. Phipps also participates in numerous community outreach activities and mentors undergraduate, graduate, medical students and residents on issues of career development and research. Her research areas include adolescent pregnancy, pregnancy outcomes, postpartum depression, prenatal care, contraception, and outcome disparities in women’s health. Dr. Phipps serves on multiple local and national committees. Dr. Phipps chairs the Rhode Island Task Force on Preterm Births which is co-sponsored by the Rhode Island Department of Health, the March of Dimes and Women & Infants Hospital of Rhode Island. Dr. Phipps also serves on numerous local committees including the RI PRAMS (Pregnancy Risk Assessment Monitoring System) Steering Committee, the Brown University Office of Women in Medicine Advisory Committee and the Rhode Island March of Dimes Board of Directors. Nationally, Dr. (continued)
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MD: University of Vermont
Phipps serves as Chair of the American College of Obstetricians and Gynecologists’ Committee on Underserved Women, Associate Editor for the American Journal of Obstetrics & Gynecology, a member of the National Institutes of Health National Children’s Study Steering Committee, an examiner for the American Board of Obstetrics and Gynecology and a member of the National Board of Medical Examiners Biostatistics and Epidemiology Task Force. Dr. Phipps is the Principal Investigator of the NIMH-funded project, Preventing Postpartum Depression in Adolescent Mothers (R34 MH077588), a clinical trial to prevent postpartum depression in adolescent mothers. Dr. Phipps is the Co-PI for the NICHD-funded Brown University/ Women & Infants Hospital National Children’s Study Center with responsibility for co-directing both the Providence County, Rhode Island and Bristol County, Massachusetts sites for this national collaborative project with Dr. Stephen Buka. Dr. Phipps is involved, as Co-investigator, in Reducing ETS Exposure of Pregnant Women and Newborns (RO1 HL070947) a project to develop an innovative intervention (tailored “take-home” videotape) to help pregnant women
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maximize their pregnancy outcome and their new infant’s health through reduction in exposure to environmental tobacco smoke (ETS) and to study the feasibility and efficacy of this intervention compared with a usual care group. Dr. Phipps is also Co-Investigator in the project Prevention of Postpartum Weight Retention (R01 DK071667) a clinical trial to evaluate an intervention to prevent excess weight gain during pregnancy and weight retention postpartum. In addition, Dr. Phipps has experience with Community-Academic Partnership research and is currently the PI for the project Improving Health and Science Literacy in a Latino Community (R03 HD05900). The overall goal of this project is to increase science and health literacy in the Latino community by delivering a science and health curriculum to a Spanish-speaking radio audience. Over the past year, Dr. Phipps was honored by membership in the American Gynecological and Obstetrical Society (AGOS) as well as with the Rhode Island Health Mothers, Healthy Babies 2010 Silver Rattle Award. Dr. Phipps was also awarded a Faculty Teacher of the Year Award and Excellence-in-Teaching Award for Undergraduate Medical Education; and a Faculty Award from the Graduating Chief Residents and an Excellence-in-Teaching Award for Resident Education. Kristen A. Matteson, MD, MPH BS: The Pennsylvania State University MD: Tufts University School of Medicine MPH: Brown University Residency: Baystate Medical Center, Tufts University School of Medicine Dr. Kristen Matteson, Assistant Professor of Obstetrics and Gynecology, is a member of the Division of Research. Dr. Matteson successfully transitioned from the Women’s Reproductive Health Research (WRHR) Scholars Program in September 2008 to her own NICHD-funded K23 mentored career development award, “A Comprehensive Patient Based Outcome Measure for Heavy Menstrual Bleeding.” Dr. Matteson started the WRHR Program in January 2006 following training in the Brown/ WIH T32 Research Fellowship in Clinical Trials and Epidemiology
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program. During her fellowship training, Dr. Matteson also earned a Masters in Public Health degree through the Brown Program in Public Health. Dr. Matteson presented her research on Abnormal Uterine Bleeding (AUB) at the First International Congress on Abnormal Uterine Bleeding held by the American Association of Gynecologic Laparoscopists and the Society for Endoscopic Gynecologists of Italy, the Annual Congress on Women’s Health, and the Annual Clinical Meeting of the American College of Obstetricians and Gynecologists. Recognizing her expertise on AUB, she was invited by the Society of Gynecologic Surgeons Systematic Review Group to serve as their clinician-researcher expert on abnormal uterine bleeding and associated patient-based outcomes measures. Dr. Matteson is an emerging leader in women’s health and research design. She is the coordinating director for the Resident Research Curriculum and the Women’s Health Fellows Workshop in Clinical Research Design. In addition, Dr. Matteson has been rewarded for her outstanding teaching skills, most notably being awarded the CREOG (Counsel on Residency Education in Obstetrics and Gynecology) Excellence in Teaching Award (National Recognimedical students for which she has been consistently awarded outstanding teacher of the year awards since 2006. With her strong leadership and research skills in women’s health, Dr. Matteson is committed to continuing mentoring students, residents, fellows and faculty. This year, Dr. Matteson was awarded with a Faculty Excellence-in-Teaching Award for Undergraduate Medical Education, a Faculty Teacher of the Year Award for Resident Education, a Faculty Excellence-in-Teaching Award for Resident Education, a Faculty Award from the Graduating Chief Residents, and the first prize poster at the 2010 APGO CREOG Annual Meeting in Orlando, Florida. Dwight J. Rouse, MD, MSPH joined the Divisions of Maternal-Fetal Medicine and Research in September of 2009 as Professor. He graduated from Harvard, received his MD from the University of Illinois (Chicago), completed a residency at the University of Iowa and a fellowship at the University of Alabama (Birmingham.) From 1994 to 2009 he was a faculty member in the Division of MaternalFetal Medicine at UAB, where he was promoted to Professor in 2003. Dr. Rouse is the Brown/WIH Principal Investigator for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units (MFMU) Network. His research is focused on clinical obstetrics, particularly labor management. Through the MFMU he has led studies on the prevention of prematurity in twins, and the prevention of cerebral palsy with magnesium sulfate. He is an author of the 23rd edition of Williams Obstetrics, and a past member of the editorial board of Obstetrics and Gynecology.
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tion Award) in 2009. Dr. Matteson is sought after as an advisor and mentor for residents and
Cynthia Rosengard, PhD, MPH BA: University of Vermont MA: University of Connecticut PhD: University of Connecticut MPH: Brown University Post-doctoral fellowship: University of California, San Francisco Dr. Cynthia Rosengard, Associate Professor of Obstetrics and Gynecology and Medicine, received her Ph.D. in Clinical Psychology from the University of Connecticut in 1994. Subsequently, she completed a two-year post-doctoral fellowship in Psychology and Medicine and Adolescent Medicine at the University of California, San Francisco and served on the faculty of the Pacific Graduate School of Psychology in Palo Alto, California for five years. She joined the Research Unit of the Division of General Internal Medicine at Rhode Island Hospital in September, 2001. In December of 2002, she was awarded a career development award from the
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National Institute of Mental Health entitled “Partner-specific Factors in Adolescent Sexual Behavior.” In September of 2006, she was awarded an independent investigator award from the National Institute on Drug Abuse entitled “Partner-specific HIV Risk Reduction for Drug Using Incarcerated Adolescents.” Dr. Rosengard serves as Co-Investigator on three additional projects with colleagues – all related to adolescent HIV risk behaviors and/or pregnancy. In May of 2005, Dr. Rosengard completed work on her masters of public health program and received her MPH from Brown University. In November of 2008, Dr. Rosengard joined the Division of Research, Department of Obstetrics and Gynecology at Women & Infants Hospital. Dr. Rosengard’s adolescent health research focuses on investigations of the influences on adolescent sexual decision-making and behavior. Her current research examines the factors that influence sexual behavior within different types of sexual partnerships and assesses these associations separately for adolescent boys and girls. Her ultimate goal is to develop interventions that will decrease the incidence of STDs and unplanned pregnancies in adolescents. Through her program of research, she plans to develop sexual risk reduction interventions that will include important attitudes, values, and expectancies found to influence partner-specific sexual decision-making in adolescents. Future research on a broader range of influential factors (i.e., family, peer, community, and culture) and additional emphasis on the development of targeted risk prevention interventions (e.g., targeting sexually inexperienced adolescents) are a part of her long-term plan of research.
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Jennifer Clarke, MD, MPH BA: Cornell University MD: Cornell University MPH: Brown University Dr. Jennifer Clarke, Associate Professor of Medicine and Obstetrics and Gynecology, received her medical degree from Cornell University and completed her residency in General Internal Medicine at Rhode Island Hospital. After residency she completed a two-year fellowship in women’s health and has been performing her clinical work at the women’s division of the Rhode Island Department of Corrections since 1998. Dr. Clarke’s research has focused on the reproductive health needs of incarcerated women. She completed an NIH-funded K23 career development award and is the Principal Investigator of project CARE funded by NICHD, a project designed to evaluate the effectiveness of motivational interviewing for family planning for women leaving prison. She is also the Principal Investigator of “Project WISE” a NIDA funded study to prevent relapse to smoking after release from prison. Dr. Clarke also received a grant among Incarcerated Women in RI”. Additionally, Dr. Clarke is a Co-Investigator on a multicenter trial of substance abuse treatment for people leaving prison (CJ-DATS). Melissa A. Clark, PhD BA: Hanover College MS: University of Illinois PhD: University of Illinois Dr. Melissa A. Clark, Associate Professor of Community Health and Obstetrics and Gynecology, is a survey methodologist with interests in survey design and data collection methodologies. Dr. Clark is the Associate Director for the Center for Population Health and Clinical Epidemiology where she directs primary data collection activities. Her research interests are in women’s health issues, and particularly the role that psychosocial factors play in health behaviors among middle-aged and older women. A consistent theme in Dr. Clark’s work is to better understand the individual, social, and environmental barriers and facilitators to health and wellbeing among individuals who have traditionally experienced disparities in overall health status and access to high quality health care. She is the Principal Investigator of a project concerning social networks and advance care planning among women with recurrent cancer. She is also the Principal Investigator of the data collection cores of two program project grants. In addition, she is the Study Director for the Providence County site of the National Children’s Study. She recently completed a series of studies about the experiences of unmarried heterosexual and sexual minority women with health care. In the past year, Dr. Clark was awarded the Dean’s Teaching Excellence Award, Alpert Medical School of Brown University.
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from the Rhode Island Foundation to evaluate “Prevalence of Obesity and Weight Change
Susan Cu–Uvin, MD BS: University of the Philippines MD: University of the Philippines Ob/Gyn Residency: Philippine General Hospital, University of the Philippines HIV/AIDS Fellowship: The Miriam Hospital, Brown Medical School Dr. Susan Cu-Uvin, Professor of Obstetrics and Gynecology and Medicine, is the Director of the Global Health Initiative at Brown University. She is also the Director of the Women and AIDS Core, for the Center for AIDS Research (CFAR) at Brown University. She was the Director of the Miriam Immunology Center until 2009. She was the Chair of the Women’s Health Committee of the Adult AIDS Clinical Trials Group (AACTG) from 2003-2006. She served on the Institute of Medicine’s Committee on Perinatal Transmission of HIV to investigate interventions to decrease vertical transmission of HIV within the United States. She currently serves on the IOM Committee on Women’s Health Research and Committee on HIV Testing and Care. She
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is a member of the Public Health Service Task Force/Perinatal Antiretroviral Guidelines Working Group, Office of AIDS Research Advisory Council, and the NIH advisory committee on HIV related research in microbicides and the HPV Working Group, USPHS/IDSA Guidelines for the Prevention and Treatment of Opportunistic Infections. She recently chaired the NIH advisory committee on HIV related research in women and girls. She is also a member of the Global Microbicide Project scientific advisory group. She is a member of the Fogarty Executive Committee at Brown University and has been a very active mentor for international trainees in HIV/AIDS care and research (Philippines, Cambodia, India, Kenya, and Indonesia). She is the recipient of the First Annual Ladies’ Home Journal Health Breakthrough Awards, the Constance B. Wofsy Women’s Health Investigator Award from the AIDS Clinical Trials Group and voted RI Woman Physician of the Year in 2007. Dr. Cu-Uvin is the Principal Investigator of an RO1 to assess antiviral therapy and HIV in the female genital tract (AI40350), and was Co-Principal Investigaor of an RO3 to assess HIV-1 genital tract shedding among Cambodian women (TW6981), and a World AIDS Foundation grant to establish a HIV women’s clinic in Cambodia and provide training to Cambodian health care professionals for research readiness for future projects related to HIV in women. She is the Principal Investigator of a Fogarty supplement to compare conventional Pap smear and visual inspection with acetic acid as a cervical cancer screening tool of HIV infected women in Western Kenya. She is a Co-Investigator of the CDC funded study to understand the natural history of HIV and AIDS in the era of highly active antiretroviral therapy (SUN). She has a K24 MidCareer Investigator Award in Patient Oriented Research. She has been a Co-Investigator and participated in multiple sub studies and study groups of the CDC sponsored HIV Epidemiology Research Study (HERS), a study on the natural history of HIV in North American women. She was a Co-Investigator of the NICHD-sponsored WHS 001 to investigate the impact of menstrual cycle and hormonal variations on HIV genital tract shedding.
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David C. Dove, PhD BA: University of Miami PhD: George Washington University Post-doctoral fellowship: Rhode Island Hospital Dr. David Dove, a psychologist, received his Ph.D. in Clinical Psychology from George Washington University in 2005. Subsequently, he completed a post-doctoral fellowship in Mental Health and HIV Prevention at the Alpert Medical School of Brown University. Dr. Dove joined the Division of Research, Department of Obstetrics and Gynecology in November 2008. His post-doctoral research focused on sexual risk reduction among adolescents, including the identification of cultural factors and the development of culturally tailored interventions. An additional line of research investigated the clinical needs and sociodemographic characteristics of black gay and bisexual men in community-based mental health treatment. Currently, Dr. Dove is working with Dr. Rosengard directing a team evaluating a sexual risk reduction intervention with at-risk substance-using adolescents involved in the juvenile justice system and conductsubstance use. Christina Raker, ScD AB: Vassar College ScM, ScD: Department of Epidemiology, Harvard School of Public Health Dr. Christina Raker joined the Division of Research as a research statistician in March, 2006. Prior to joining the division, she was involved in the design and analysis of case-control and longitudinal studies of oncogenic viral infections in community-based populations. In addition, she has research experience in virology, immunology, and genetic epidemiology. Her current interests include the application of epidemiologic and biostatistical methods in clinical research. Dr. Raker is involved in research design and analysis for members of the Department of Obstetrics and Gynecology, including faculty, fellows and residents. She lectures in the Fellow’s Course in Clinical Research Design and the Resident Research Curriculum.
EDUCATIONAL FUNCTIONS Medical Students Drs. Phipps and Matteson participate in teaching of undergraduate and medical students by serving as preceptors for medical students in the Obstetrics and Gynecology core clerkship, undergraduate students undertaking an independent study semester course—Reproductive Epidemiologic Research, and medical students in the Community Health Clerkship. In addition, Drs. Phipps and Matteson provide hands–on clinical instruction to medical students through their work in triage, the Women’s Primary Care Center, labor and delivery and the operating room. Didactic sessions with the medical students often focus on Cervicitis, Vaginitis and Sexually Transmitted Infections. (continued)
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ing a web-based longitudinal assessment of alternative school students’ sexual behavior and
Residents Drs. Phipps and Matteson provide teaching through clinical work in the triage unit, the Women’s Primary Care Center, labor and delivery, and the operating room. Didactic sessions with obstetrics and gynecology residents include: Cervicitis, Vaginitis and Sexually Transmitted Infections; Abnormal Uterine Bleeding: First Trimester Bleeding; Adolescent Pregnancy; Clinical Research Design and Methods; Research Ethics; Biostatistics; Study Design; and Evidence– Based Medicine. In September 2006, Drs. Matteson, Phipps, Sung and Anderson launched the newly developed Obstetrics and Gynecology Resident Research Curriculum. The two-year curriculum covers research design, database development, analysis, statistics, ethics, and critical appraisal of the medical literature, career development and resident research project development. Two sessions per month during core curriculum are dedicated to the resident research curriculum. One of these sessions includes a didactic seminar with the following session including a journal club review that complements the didactic session. The course is undergo-
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ing evaluation, including pre-course, mid-course and final assessments. Dr. Matteson is the coordinating director for the Resident Research Curriculum and the Resident Research requirement. She organizes and directs the annual Resident Research Day that is coordinated with the annual Departmental Saphire Lecture. The Division of Research supports resident research projects throughout the year including research design and development, database development, statistical support, abstract development, as well as oral and poster presentation preparation. Fellows The Women’s Health Fellows Workshop on Clinical Research Design, directed by Dr. Matteson, successfully completed its ninth consecutive year. Initiated in 2002, this popular two-week course involves clinical fellows from the Departments of Obstetrics and Gynecology, Neonatology, Internal Medicine, Pathology, Pediatrics and Emergency Medicine. The curriculum includes sessions on study design methodology, data base management, statistics, ethics, academic promotion, grant writing and research proposal development. Women’s Reproductive Health Research Scholars (WRHR) (NIH-funded K12 program) The Brown University / Women & Infants Hospital WRHR program was initially funded in 2005 and was recently awarded an additional 5 years of NIH funding allowing for new scholar appointments through 2015. The purpose of the Brown / WIH WRHR program is to train the next generation of women’s health translational researchers that have the expertise and research skills to develop innovative research in women’s reproductive health from basic science to clinical applications relevant to public health. The overarching goal of the Brown / WIH WRHR program is to provide a supportive and stimulating research environment that enables wellqualified, junior faculty physician-scientists to develop into well-funded leaders in women’s reproductive health research with expertise in clinical translational research. The training program involves a tailored research and career development plan that works through intensive multidisciplinary mentoring, didactic seminars and practical hands-on research investigation. 92
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The career objectives for each scholar are focused on: acquiring the necessary knowledge and research skills in relevant scientific areas as well as key areas in women’s health and translational research; professional development including management and leadership skills; and, developing the foundation for an independent research career through an intensive mentored research experience. Scholars are expected to actively write grants to the level of R01, or program project grants as they transition through and beyond the program and to continue to mentor and interact with the program even after independent funding is achieved. WRHR Program leadership •
Joanna Cain, MD, Principal Investigator
•
Maureen G. Phipps, MD, MPH, Program Director
Current WRHR scholar: •
Katina Robison, MD Program in Women’s Oncology (March 30, 2009 to present)
Previous WRHR scholars: Brenna Anderson, MD, MS Division of Maternal-Fetal Medicine
(July 1, 2006 to August 10, 2009)
•
Kristen Matteson, MD, MPH, Division of Research (January 1, 2006 – August 31, 2008)
•
Vivian Sung, MD, MPH Division of Urogynecology (July 1, 2006 – June 15, 2009)
NATIONAL CENTER OF EXCELLENCE IN WOMEN’S HEALTH The Brown University National Center of Excellence in Women’s Health has been led by Dr. Maureen Phipps since 2003. Brown University and Women & Infants Hospital of Rhode Island were designated as a National Center of Excellence in Women’s Health by the U.S. Department of Health and Human Services in October of 2003. The mission of the CoE has been focused on improving health and health care for all women by working with academic and community partners and collaborating with public and private health care providers throughout the state. Although the national program ended in September 2007, the commitment to continue to work toward the mission and goals has continued. The CoE was successful because of the dedicated network of partners located throughout Rhode Island working on initiatives that include: •
Enhancing the professional development of women residents, fellows and faculty leading
to academic promotion and positions of leadership throughout the university;
•
Promoting education, training and advancement of women in nursing and allied health
professions;
•
Improving the medical curriculum in women’s health throughout the medical school
residency and post graduate programs, with an emphasis on diversity and cultural issues;
•
Enhancing collaborative efforts of women’s health researchers statewide, regionally
and nationally;
•
Providing community health education, outreach and health services to diverse groups
of women;
•
Improving quality and access to care for women of all ages, emphasizing the specific needs
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•
CoE Outstanding Faculty Mentor Award: Established in 2005, the Outstanding Faculty Mentor Award recognizes faculty members throughout the Brown Community who have been instrumental in the career development of junior faculty pursuing careers in women’s health and leadership. The faculty members are nominated by their mentees and selected by the CoE leadership team. In 2010, two faculty members received this prestigious award: •
Caron Zlotnick, PhD, Professor, Department of Psychiatry & Human Behavior at the Warren
Alpert Medical School of Brown University and Director of Research for Women’s
Behavioral Health at Women & Infants Hospital (October, 2009)
•
Donald R. Coustan, MD, Professor of Obstetrics & Gynecology at the Warren Alpert
Medical School of Brown University and Women & Infants Hospital, Division of
Maternal-Fetal Medicine (March, 2010)
Innovations in Women’s Health Research Seed Grant: The Center of Excellence Innovations
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in Women’s Health Seed Grant program was established in 2005 to support activities necessary to advance interdisciplinary projects in women’s health and gender-based research and education. The goal of the program is to support high quality projects to help attract external funding from federal and foundation sources. The program requires that proposals have a realistic potential for future success in attracting external support. Funds should be applied to pilot research necessary to advance such proposals. These funds are not intended to supplement ongoing NIH funded projects, but rather to stimulate new research and interdisciplinary collaborations. In consultation with an ad hoc committee of faculty advisors, awards are made by the Brown University National Center of Excellence in Women’s Health (CoE). On-going support for the program has been received from numerous medical school departments and the dean’s office. Since the inception of the program in 2005, fourteen Research Seed Grants and two Education Seed Grants have been awarded. The 2010 Innovations in Women’s Health Research Seed Grant include:
Title: A polymorphic variant at survivin 129 is a novel biomarker for breast cancer
Principal Investigator: Rachel Altura (Pediatrics)
Brown Collaborators: Carmen Marsit (Pathology), Evgeny Yakirevich (Pathology)
Title: Susceptibility genes for polycystic ovarian syndrome in Somoan and
American Somoan women
Principal Investigator: Geralyn Lambert-Messerlian (Pathology)
Brown Collaborators: Stephen McGarvey (Community Health)
Other Collaborators: Ranjan Deka (Cincinnati, Genotyping lab), Margrit Urbanek
(Northwestern, Medicine)
Title: Role of sleep and circadian rhythm disruption in postpartum depression
Principal Investigator: Katherine Sharkey (Medicine)
Brown Collaborator: Teri Pearlstein (Psychiatry & Human Behavior)
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RESEARCH ACTIVITIES The goal of the Division of Research is to develop and support original research which will lead to improved patient and community outcomes. The Division of Research works to increase grant funding in the Department of Obstetrics and Gynecology, support publication of the research activities in the Department, enhance the careers of junior investigators and provide support for clinical investigators in the Department of Obstetrics and Gynecology. The work of the Division of Research is driven by collaboration, education, training and investigator support. The backgrounds of the multidisciplinary staff members in the Division of Research include nursing, epidemiology, statistics, psychology, database development, business management, public health research coordination, and research support. The Division of Research in Women’s Health provides the following services to members of the Department of Obstetrics and Gynecology and Women and Infants: 1) consultation regarding 2) data management and entry; 3) statistical analyses; 4) expertise in project coordination; and 5) outcomes measurement and research. The George Anderson Outcomes Unit, established in 1997, is integrated within the Division of Research. The Outcomes Unit focuses its efforts on patient–oriented outcomes research in the Department of Obstetrics and Gynecology, and the hospital. The integration of these services maximizes the efficiency of both the Division and the Outcomes Unit. By providing essential services for the department and the hospital, the Division has encouraged clinical investigation and increased the NIH grant support to the Department of Obstetrics and Gynecology.
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epidemiology, methodology, project planning, biostatistics, publishing, and grant applications;
GRANTS Clarke JG: NIH NICHD “Empowering Women to Make Contraceptive Choices While Incarcerated.” (PI: J Clarke) $1,484,579 grant total. 6/1/08-5/31/13. Clarke JG: NIH NIDA “Sustaining Tobacco Abstinence after Incarceration.” (PI: J Clarke) $908,875 grant total. 8/15/09-7/31/11. Clark MA: NIH NCI “Understanding Reversed Race/Ethnic Associations with Cancer Screening Tests” (PI: Rakowski) Co-Investigator for project. $125,387 direct costs, 4/07 − present. Clark MA: NIH NIA “Older Latina Women. Marital Status and Cancer Screening” (PI: Wasserman) Co-Investigator for project. $11,366 direct costs, 3/07 − present.
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Clark MA: NIH NCI “Methods and Measures Core (PI) and Social Contexts and Patterns of Young Adult Smoking (Co-I) (PI: Rende) “Renewal of the Transdisciplinary Tobacco Use in Research Centers”. (PI: Niaura) (P50-CA04012), $424,535 direct costs, 10/04 − present. Clark MA: NIH NIA “Primary Data Collect Core (Core PI), Program Project Grant, “Long-Term Care in America” (PI: V Mor) $1,333,093 direct costs, 9/2007− present. Clark MA: NIH NICHD “The National Children’s Study—Providence and Bristol County Sites”. (PI: S Buka, Co-PI M Phipps), Co-Investigator and Operations Manager for project. $1,495,650 (Providence) and $424,829 (Bristol) direct costs, 9/07 − present. Clark MA: Subcontract to Providence VA “A Computer Adaptive Test to Measure Community Reintegration.” (PI: L Resnik) Co-Investigator for project. $102,594 direct costs, 3/08 − present. Clark MA: NIH NCI “Classification Tree Analysis to Enhance Targeting for Cancer Screening Programs.” (PI: W Rakowski), $103,750 direct costs, 1/10 – present. Clark MA: Subcontract (PI for subcontract) “Video-Based HIV Testing for Latinos.” (PI: R Merchant), $18,806 direct costs, 3/10 – present. Clark MA: NIH NCI “Social Networks and Care Planning for Women with Cancer.” (PI) $116,971 direct costs, 4/10 - present. Cu-Uvin S: NIAID K24 AI066884-05. “Antiviral Therapy and HIV in the Genital Tract of Women.” (PI: S Cu-Uvin) $136,653 yr; 8/15/05-6/30/10. Cu-Uvin S: NIAID R01 5U01AI6605. “S.japonicum and Birth Outcomes: Randomized Controlled Trial.” (PI: A Friedman) Co-Investigator. $18,870 yr; 4/1/06-3/31/11. Cu-Uvin S: NIH FIC “Interdisciplinary Framework in Global Health at Brown University.” (PI: S Cu-Uvin) $125,000 yr; 8/10/08-7/31/11. Cu-Uvin S: NIH NIAID “HIV and Women’s Core.” Lifespan/Tufts/Brown Center for AIDS Research (PI: Carpenter) Co-Director, $111,526 yr, 9/1/98-6/30/12. Cu-Uvin S: NIH NIAID “Adult Therapeutic Clinical Trials Program for HIV/AIDS.” (PI: Tashima) $435,000 yr, 12/1/06-11/30/13. Cu-Uvin S: CDC “Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN).” (PI: Carpenter) $424,822 yr, 9/27/07-9/28/11. Cu-Uvin S: NIH NIAID “Molecular T. Vaginalis Host Interactions in Relevance to Inflammatory Sequelae.” (PI: Fichorova) 29,992 yr, 7/1/09-6/30/13. 96
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Matteson KA: NIH NICHD “Mentored Patient-Oriented Research Career Development Award - A Comprehensive Patient Based Outcome Measure for Heavy Menstrual Bleeding.” (1K23 HD057957 (Matteson)). PI. $739,932 grant total. 9/1/08-9/31/13. Phipps MG: NIH NIDDK “Prevention of Postpartum Weight Retention.” (R01DK071667 (Phelan)). Site PI, Co-Investigator for project. $1,369,059 grant total. 9/11/06-08/31/10. Phipps MG: NIH NICHD “Improving Health and Science Literacy in a Latino Community (ESCUCHE).” (1R01 3 HD05900-02 (Phipps and Rodriquez)) PI. $56,686 grant total. 9/25/08-8/31/10. Phipps MG: NIH NICHD “Brown University/Women and Infants National Children’s Study (Providence County, Rhode Island).” (HH SN 267200700032C ( Buka and Phipps)). PI. $5,420,356 grant total. 9/27/07-9/26/12. Phipps MG: NIH NICHD “Brown University/Women and Infants National Children’s Study (Bristol County, Massachusetts).” (HH SN 275200800017C (Buka and Phipps)). PI. $4,287,866 grant total. 9/30/08-9/29/13.
Phipps MG: NIEHS “Formative Center for the Evaluation of Environmental Impacts on Fetal Development: Tissue Procurement Core.” Site PI. $114,047 (Subcontract) 12/1/09-2/1/12. Rouse DJ: ( PI) and Anderson BL (Alternate Principal Investigator) Cooperative Multicenter Maternal Fetal Medicine Units Network. NICHD. PHS#5-U10 – HD40500-05. 9/6/05-3/31/10.
INVITED PRESENTATIONS (LOCAL) Clarke JG: “Introduction to Research.” Resident Noon Conference. Brown University School of Medicine, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, September 2009. Clarke JG:“A 25 Year Old Pregnant Incarcerated Women.” OB-Gyn Grand Rounds Beth Israel Deaconess Medical Center, Boston, Massachusetts, January 2010. Clarke JG: Panelist, “The Life of a Clinician Researcher.” Brown University, The Office of Women in Medicine, Providence, Rhode Island, February 2010. Cu-Uvin S: Special Health Concerns of HIV Infected Women, 6th Annual Teaching Day: “Focusing on HIV and Women.” Association of Nurses in AIDS Care, Radisson Hotel, Providence, Rhode Island, September 2009. Cu-Uvin S: “Brown and the World: Engaging HIV Infected Women.” Saphier Family Lecture in Obstetrics and Gynecology, Women and Infants Hospital, Providence, Rhode Island, May 2010. Cu-Uvin S: “Gender Issues in HIV.” 14th Annual Meeting, HIV Update, Contemporary Issues and Management, Harvard Medical School and Beth Israel Deaconess Medical Center. Seaport Hotel, Boston, Massachusetts, June 2010. Cu-Uvin S: Course Director: “Women, HIV and Rhode Island’s New Testing Law.” Providence Hilton Hotel, Providence, Rhode Island, June 2010.
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Phipps MG: NIH NICHD “Brown University/Women and Infants Women’s Reproductive Health Research Career Development.” (2K12 HD0501080-06 Cain)). PD. $2,200,000 Grant total. 9/27/05-3/31/15.
Phipps MG: “Understanding Adolescent Pregnancy: Policy, Data and Research.” The Warren Alpert Medical School of Brown University, Department of Pediatrics Grand Rounds, Providence, Rhode Island, August 2009. Phipps MG: “Translational Research in Women’s Health, From Basic Science to Bedside to Community.” New Dimensions and Strategies for Women’s Health Research for the National Institutes of Health. Office of Research in Women’s Health Strategy Conference and Public Hearing. Hosted by Brown University and Women & Infants Hospital, Providence, Rhode Island, September 2009. Phipps MG: “Rhode Island Task Force on Premature Births: 2009 Progress Report.” 2009 Rhode Island March of Dimes Prematurity Summit. Providence, Rhode Island, November 2009.
INVITED PRESENTATIONS (NATIONAL)
R e s e a r c h i n W o m e n ’s H e a l t h
Cu-Uvin S: “Clinical Parameters Essential to Methodology and Interpretation of Mucosal Responses.” Mucosal Immunity in the Male and Female Reproductive Tract and The Prevention of HIV Transmission Meeting, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, July 2010. Cu-Uvin S: “Vulnerable Populations: Why Can’t We Protect Men and Women from HIV with the Knowledge we Have?” Mucosal Immunity in the Male and Female Reproductive Tract and The Prevention of HIV Transmission Meeting, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, July 2010. Matteson KA: “Hysterectomy Compared to Other Therapies for Abnormal Uterine Bleeding. Why Should we Care?” Part of the Systematic Review Group panel at the meeting for the Society for Gynecologic Surgeons, Tucson, Arizona, April 2010. Phipps MG: “Understanding Adolescent Pregnancy: Policy, Data and Research.” University of Wisconsin, Department of Obstetrics and Gynecology Grand Rounds, Madison, Wisconsin, August 2009. Phipps MG: “The Rhode Island Task Force on Premature Birth.” Symposium on Quality Improvement to Prevent Prematurity. Sponsored by March of Dimes, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, American College of NurseMidwives, Association of Women’s Health, Obstetrics and Neonatal Nurses. Arlington, Virginia, October 2009. Phipps MG: “Adolescent Pregnancy: Policy, Data and Research.” Guest Consultant for Resident Graduation Day Albany Medical College, Department of Obstetrics, Gynecology and Reproductive Sciences, Albany, New York, June 2010. Rouse DJ. Current Trends and New Direction in Ob/Gyn Seminar: MgSO4 for the Prevention of CP. Mount Auburn Hospital, Waltham, MA. November 18, 2009. Bates E, Rouse DJ, Chapman V, Mann ML, Carlo W, Tita A. Fetal lung maturity testing before 39 weeks and neonatal outcomes. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Rouse DJ. Spring Postgraduate Course. University of Michigan Department of Obstetrics and Gynecology, Detroit, MI. April 2010. Rouse DJ. Resident Research Symposium. University of South Carolina School of Medicine, Columbia, SC. June 2010. Rouse DJ. Sloane Symposium. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY. June 2010. 98
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INVITED PRESENTATIONS (INTERNATIONAL) Cu-Uvin S: “HIV and Women.” Presented at the 2010 HIV/AIDS Nursing Symposium, Chennai, India, January 2010. Matteson KA: “Structuring the Menstrual History.” Part of the Abnormal Uterine Bleedin panel at XIX World Congress of FIGO, Cape Town, South Africa, October 2009.
ABSTRACT PRESENTATIONS (LOCAL) Clark MA. Homegrown: Experiences and Reflections on the Challenges and Rewards of Using Community-Based Learning. Brown University Swearer Center & Sheridan Center, Providence, Rhode Island, 2009. van den Berg JJ, Lopez R, Dove DC, Morrow KM, Stein LAR, and Rosengard C. Teenspeak: The Language of Inner-city Adolescents’ Sexual Behaviors and Sexual Relationships. Presented at the CFAR Social and Behavioral Sciences Research Network National Scientific Meeting, Boston, Massachusetts, October 2009.
Waxman, MJ, Merchant RC, Clark MA, Maher JG, Celada,MT, Beckwith CG, Liu T, Simmons EA, and Mayer KH. Will the 2006 CDC HIV testing recommendations reduce stigma and increase HIV testing? 2009 CDC National HIV Prevention Conference, Atlanta, Georgia, 2009. Merchant RC, Waxman MJ, Clark MA, Maher JC, Celada MT, Beckwith CG, Liu,T, Simmons EA, and Mayer KH. Do patients and clinicians have ethical concerns about the 2006 CDC HIV testing recommendations? 2009 CDC National HIV Prevention Conference, Atlanta, Georgia, 2009. Sung VW, Williams DA, Rogers RG, Myers DL, Marques F, and Clark MA. Content validity of the “PROMIS” framework in women with urinary incontinence. Annual Meeting of the American Urogynecologic Society, Hollywood Florida, 2009. Rakowski W, and Clark MA. Unwanted sex and partner violence: mammography and pap testing in the 2006 BRFSS. Annual meeting of the Society of Behavioral Medicine. Montreal, Canada, 2009. Politi MC, Clark MA, Ombao H, and Légaré F. The impact of a mismatch between patients’ and providers’ reactions to uncertainty on patients’ breast health decisions and decision satisfaction. Annual Meeting of the Society for Medical Decision Making, Hollywood, California, 2009. Rogers ML, Clark MA,Rakowski W, and Linkletter CD. Racial and ethnic differences in onschedule mammography screening: results from the Behavioral Risk Factor Surveillance System. Annual Meeting of the American Association of Public Opinion Research, Chicago, Illinois, 2010. Anderson BL, Cu-Uvin S, Raker C, Hillier SL. Subtle perturbations of genital microflora alter immunity among low risk pregnant women. Oral presentation at the 36th Annual Scientific Meeting of the Infectious Diseases Society for Obstetrics and Gynecology, Montreal, Canada, August 2009. Kassis N, Jayakrishnan A, Sprawka N, Cu-Uvin S, Anderson BL. Hepatotoxicity and metabolic acidosis manifested as non-reassuring fetal testing in a pregnant women on antiretroviral (continued)
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ABSTRACT PRESENTATIONS (NATIONAL)
therapy. Poster presentation at the 36th Annual Scientific Meeting of the Infectious Diseases Society for Obstetrics and Gynecology, Montreal, Canada, August 2009. Nijhawan A, McManus J, Liu T, Delong A, Chapman S, Rapoza K, Kurpewski J, Caliendo A, Cu-Uvin S. The effect of acyclovir on CD4 count and CD4 percent slope in HIV-1/HSV-2 co-infected women taking HAART. Annual IDSA Meeting, Philadelphia, Pennsylvania, October 2009. McManus J, Nijhawan A, Liu T, Delong A, Chapman S, Rapoza K, Kurpewski J, Caliendo A, Cu-Uvin S. The effect of acyclovir on prevalence of bacterial vaginosis in HIV-1/HSV-2 co-infected women taking HAART. Annual IDSA Meeting, Philadelphia, Pennsylvania, October 2009.
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Anderson BL, Wira CR, Fitzsimmons C, Ghosh M, Fahey J, Cu-Uvin S. Cervicovaginal fluid from pregnant and non-pregnant women suppresses HIV infectivity in an in vitro model. Oral presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, Chicago, Illinois, February, 2010. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S43. Anderson BL, Hillier SL, Raker C, Fitzsimmons C, Cu-Uvin S. Maternal inflammatory mediators are increased as early as the first trimester in low risk pregnancies. Poster presentation at the 30th Annual Meeting of the Society for Maternal Fetal Medicine, Chicago, Illinois, February, 2010. American Journal of Obstetrics and Gynecology 2009;201(6, Supplement 1):S231. van den Berg JJ, Lopez R, Dove DC, Morrow KM, Stein LAR, and Rosengard C. African American and Latino/a adolescents’ sexual relationship perceptions and motivations. Presented at the Annual Meeting of the American Psychological Association Conference, Toronto, Canada, August 2009. van den Berg JJ, Lopez R, Dove DC, Morrow KM, Stein LAR, and Rosengard C. Participantidentified intervention components and facilitator characteristics for an HIV risk reduction program among incarcerated adolescents. Presented at the Annual Meeting of the American Public Health Association Conference, Philadelphia, Pennsylvania, November 2009. Li S, Dove DC, van den Berg JJ, Lopez R, Audet D, Morrow KM, Stein LAR, and Rosengard C. Sexual health learning and partner communication about sexually transmitted disease/HIV risk: Incarcerated adolescents’ perspectives. Presented at the Annual Meeting of the Society for Adolescent Medicine, Toronto, Canada, April 2010. Critchfield AR, Matteson KA, Lievense S, Raker CR. Intrapartum Group B Streptococcus Prophylaxis in patients who report a penicillin allergy: has there been an improvement in adherence to the 2002 CDC Guidelines? Oral presentation at the Infectious Disease Society of Obstetrics and Gynecology, Montreal, Quebec, Canada, August 2009. Carey M, Matteson KA, Masterton D, Raker CR. Misoprostol for non-viable first trimester pregnancies – Can patients accurately determine spontaneous miscarriage completion? Oral presentation at the American Society for Reproductive Medicine, Atlanta, Georgia, October 2009. Matteson KA, Anderson BL, Sung VW, Raker CA, McMahon M, Phipps MG. Development and evaluation of a formal research curriculum for obstetrics and gynecology. Poster Presentation at the APGO CREOG Annual Meeting, Orlando, Florida, March 2010. Matteson KA, Phipps MG, Peipert JF. Developing a workshop on research design for clinical fellows. Poster Presentation at the APGO CREOG Annual Meeting, Orlando, Florida, Awarded First Prize, March 2010. Phipps MG, Rodriguez P. Improving health and science literacy in a Latino Community. National Institutes of Health Partners in Research Investigator Workshop. Bethesda, Maryland, October 2009. 100
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Sung VW, Raker CA, Myers DL, and Clark MA. Ambulatory care for female pelvic floor disorders in the United States. Annual Meeting of the Society of Gynecologic Surgeons, New Orleans, Louisiana, 2009.
ABSTRACT PRESENTATIONS (INTERNATIONAL) Harwell J, Lim K, DeLong A, Srey P, Thay S, Tharpe L, Ingersoll J, Caliendo A, Cu-Uvin S. Changes in plasma (PVL) and genital tract (GTVL) HIV-1 viral loads in Cambodian women initiating generic antiretroviral therapy. International Conference on AIDS in Asia and Pacific, Bali, Indonesia, August 2009.
PEER REVIEWED PUBLICATIONS Havens JR, Leukefeld C, Oser CB, Staton-Tindall M, Knudsen HK, Mooney J, Duvall J, Clarke JG, Frisman L, Surratt H and Inciardi J. An Examination of Protocol Performance and Adherence among Criminal Justice Involved Women Prisoners Receiving an HIV Intervention. Journal of Experimental Criminology 5(3):245, 2009.
Clarke JG, Phipps MG, Tong I, Rose J, Gold M. Timing of conception for pregnant women returning to jail. Journal of Correctional Health Care 16(2):133-8, 2010. Nijhawan AE, Salloway R, Nunn AS, Poshkus M, Clarke JG. Preventive healthcare for underserved women: results of a prison survey. Journal of Womens Health (Larchmt) 19(1):1722, 2010. Politi MC, Clark MA, Armstrong G, McGarry KA, and Sciamanna CN. Patient-provider communication about sexual health among unmarried middle-aged and older women. Journal of General Internal Medicine 24(4):511-516, 2009. Pasick R, Burke N, Barker J, Joseph G, Bird J, Otero-Sabogal R, Nuason N, Stewart S, Rakowski W, Clark MA, Washington P, and Guerra C. Behavioral theory in a diverse society: like a compass on mars. Health Education and Behavior 36:11S-35S, 2009. Burke N, Bird J, Clark MA, Rakowski W, Guerra C, Barker J, and Pasick R. Social and cultural meaning of Sself-efficacy. Health Education and Behavior 36:111S-128S, 2009. Clough-Gorr KM, Rakowski W, Clark MA, and Silliman RA. The Getting-Out-of-Bed (GoB) measure of motivation and life outlook in older adults: development and initial psychometric evaluation in a sample of older breast cancer survivors. Journal of Psycho-Oncology 27(4):454468, 2009. Merchant RC, Clark MA, Langan TJ, Seage GR, Mayer KH, and DeGruttola VG. Effectiveness of increasing emergency department patients’ self-perceived risk for being HIV infected through audio-computer self-interview (ACASI)-based feedback about reported HIV risk behaviors. Academic Emergency Medicine 16:1143-1155, 2009. Dizon DS, Schutzer ME, Politi M, Linkletter C, Miller S, and Clark MA. Advance care planning decisions of women with cancer: Provider recognition and stability of choices. Journal of Psychosocial Oncology 27(4):383-395, 2009. (continued)
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Stein MD, Caviness CM, Anderson BJ, Hebert M, Clarke JG. A brief alcohol intervention for hazardously drinking incarcerated women. Addiction 105(3):466-75, 2010.
Rakowski W, Clark, MA, Rogers ML, and Weitzen S. Investigating reversals of association for utilization of recent mammography among Hispanic and non-Hispanic black women. Cancer Causes and Control 20:1483-1495, 2009. Schneider K, Lapane K, Clark MA, and Rakowski W. Using small area estimation to describe county-level disparities in mammography. Preventing Chronic Disease: Public Health Research, Practice and Policy 6(4):A125, 2009. Clark MA, Rogers ML, Wen X, Wilcox V, McCarthy-Barnett K, Panarace J, Manning C, Allen S, and Rakowski W. Repeat mammography among unmarried women with and without a disability. Women’s Health Issues 19:415-424. 2009. Fennell ML, Feng Z, Clark MA, and Mor V. Disparities in nursing home use and performance: The case of elderly U.S. Hispanics. Health Affairs 29(1):65-73, 2010.
R e s e a r c h i n W o m e n ’s H e a l t h
Merchant RC, Freelove SM, Langan TJ, Clark, MA, Mayer KH, Seage GR, and DeGruttola VG. The relationship of reported HIV risk and history of HIV testing among emergency department patients. Postgraduate Medicine 122(1):61-74, 2010. Miller EA, Mor V, and Clark MA. Reforming long-term care in the United States: findings from a national survey of specialists. The Gerontologist 50(2):238-252, 2010. Rakowski W, Wyn R, Breen N, Meissner H, and Clark MA. Prevalence and correlates of recent and repeat mammography among California women ages 55-79. Cancer Epidemiology 34(2):168-177,2010. Kahler CW, Leventhal AM, Daughters SB, Clark MA, Colby SM, Ramsey SE, Boergers J, Abrams DB, Niaura R, and Buka SL. Relationships of personality and psychiatric disorders to multiple domains of smoking motives and dependence in middle-aged adults. Nicotine & Tobacco Research 12(4):381-389, 2010. Cohen A, Lopez A, Marder S, Safane N, and Clark MA. Lessons from an Introductory Public Health Course. Academic Exchange Quarterly 14(1): 158-163, 2010. Kojic EM, Wang CC, Firth JA, Gopalakrishnan G, Cu-Uvin S. Special care issues of women living with HIV/AIDS. Medicine Health RI 92(7):229-30, 2009. Gillani FS, Zaller ND, Zeller K, Rich JD, Cu-Uvin S, Flanigan TP, Carpenter CC. Changes in demographics and risk factors among persons living with HIV in an academic medical center from 2003-2007. Medicine Health RI 92(7):237-40, 2009. Moreira C, Venkatesh KK, DeLong A, Liu T, Kurpewski J, Ingersoll J, Caliendo AM, Cu-Uvin S. Effect of treatment of asymptomatic bacterial vaginosis on HIV-1 shedding in the genital tract among women on antiretroviral therapy: a pilot study. Clinical Infectious Diseases 15;49(6):9912, 2009. Mitchell C, Moreira C, Fredricks D, Paul K, Caliendo AM, Kurpewski J, Ingersoll J, Cu-Uvin S. Detection of fastidious vaginal bacteria in women with HIV infection and bacterial vaginosis. Infectious Diseases in Obstetrics and Gynecology 2009;2009:236919. Ghosh M, Shen Z, Fahey JV, Cu-Uvin S, Mayer K, Wira CR. Trappin-2/Elafin: a novel innate anti-human immunodeficiency virus-1 molecule of the human female reproductive tract. Immunology 129(2):207-19, 2010. Ghosh M, Fahey JV, Shen Z, Lahey T, Cu-Uvin S, Wu Z, Mayer K, Wright PF, Kappes JC, Ochsenbauer C, Wira CR. Anti-HIV activity in cervical-vaginal secretions from HIV-positive and -negative women correlate with innate antimicrobial levels and IgG antibodies. PLoS One 29;5(6):e11366, 2010. 102
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Theiler RN, Farr SL, Karon JM, Paramsothy P, Viscidi R, Duerr A, Cu-Uvin S, Sobel J, Shah K, Klein RS, Jamieson DJ. High-risk human papillomavirus reactivation in human immunodeficiency virus-infected women: risk factors for cervical viral shedding. Obstetrics and Gynecology 115(6):1150-8, 2010. Matteson KA, Boardman L, Clark MA, Munro MG. Abnormal uterine bleeding: A review of patient-based outcome measures. Fertility and Sterility 92(1):205-16, 2009. Matteson KA, Phipps MG, Raker C, Sacco LJ, Jackson AL. Discussion: ’Laparoscopic versus vaginal hysterectomy for benign pathology’ by Candiani et al. American Journal of Obstetrics and Gynecology 200(4):e1-6, 2009. Einarsson JI, Matteson KA, Schulkin J, Chavan NR, Sangi-Haghpeykar K. Minimally invasive hysterectomies - A survey on attitudes and barriers among practicing gynecologists. Journal of Minimum Invasive Gynecology 17(2):167-175, 2010. Matteson KA, Clark MA. Questioning our Questions: Do frequently asked questions adequately cover the aspects of women’s lives most affected by abnormal uterine bleeding? Opinions of women with abnormal uterine bleeding participating in focus groups. Women and Health 50(2):195-211, 2010.
Stein MD, Anderson BJ, Caviness CM, Rosengard C, Kiene S, Friedmann P, Clark JG. Relationship of alcohol use and sexual risk taking among hazardously drinking incarcerated women: an event-level analysis. Journal of Study on Alcohol and Drugs 70(4):508-15, 2009. Grobman W, Lai Y, Landon M, Spong C, Leveno K, Rouse DJ, et al. Can a prediction model for vaginal birth also predict the probability of morbidity related to a trial of labor? Am J Obstet Gynecol 2009;200:56.e1-6. Caritis SN, Rouse DJ, Peaceman AM, et al. Prevention of preterm birth in triplets: An evaluation of 17-alpha hydroxyprogesterone caproate. Obstet Gynecol 2009;113:285-292. Tita AT, Rouse DJ. Progesterone for the prevention of preterm birth: An evolving intervention. Am J Obstet Gynecol 2009;200:219-224. Tita AT, Rouse DJ, Saade G, et al. Evolving concepts in antibiotic prophylaxis for cesarean delivery: a systematic review. Obstet Gynecol 2009;113:675-682. Doyle LW, Crowther CA, Middleton P, Marret S, Rouse DJ. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD004661. DOI: 10.1002/14651858.CD004661.pub3. Newman RB, Momirova V, Dombrowski MP, Schatz M, Wise R, Landon M, Rouse DJ, et al. The Effect of Active and Passive Household Cigarette Smoke Exposure on Pregnant Women with Asthma. Chest 2010;137:601-8.
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Pregler J, Freund KM, Kleinman M, Phipps MG, Fife RS, Gams B, Núñez AE, Seaver R, Lazarus CJ, Raymond NC, Uijtdehaage S, Guiton G, David M, Gabeau GV, Geller S, Meekma K, Moore C, Robertson C, Sarto G. The heart truth professional education campaign on women and heart disease: needs assessment and evaluation results. The Journal of Women’s Health 8(10):15417, 2009. Sung VW, Raker CA, Myers DL, and Clark MA. Ambulatory care related to female pelvic floor disorders in the United States, 1995-2006. American Journal of Obstetrics and Gynecology 201(5):508.e1-6, 2009.
Landon, MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, Wapner RJ, Varner MW, Rouse DJ, et al. A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes. New Engl J Med 2009; 361:1339-48. Dinsmoor MJ, Gilbert S, Landon MB, Rouse DJ, et al. Perioperative Antibiotic Prophylaxis for Nonlaboring Cesarean Delivery. Obstet Gynecol 2009;114:752-6. Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al. Does Information Available at Admission for Delivery Improve Prediction of Vaginal Birth after Cesarean? Amer J Perinatol 2009;26:693-701. Rouse DJ, Weiner S, Bloom SL, et al. Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes. AJOG 2009;201:357.el-7.
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Gyamfi C, Horton AL, Momirova V, Rouse DJ, et al. The effect of 17-alpha hydroxyprogesterone caproate on the risk of gestational diabetes in singleton or twin pregnancies. AJOG 2009;201:392.el-5. Killam WP, Tambatamba BC, Chintu N, Rouse DJ, Stringer E, Bweupe M, Yu Y, Stringer JS. Antiretroviral therapy in antenatal care to increase treatment initiation in HIV-infected pregnant women: a stepped-wedge evaluation. J AIDS 2010:24:85-91. Cormier C, Landon M, Lai Y, Spong C, Rouse DJ, et al. White’s Classification of Maternal Diabetes and Vaginal Birth After Cesarean Delivery Success in Women Undergoing a Trial of Labor. Obstet Gynecol 2010;115:1:60-4. Bates E, Rouse DJ, Chapman V, Mann ML, Carlo W, Tita A. Fetal lung maturity testing before 39 weeks and neonatal outcomes. Society of Maternal-Fetal Medicine Poster Presentation, Chicago IL, February 2010. Harper M, Thom E, Klebanoff M, Thorp J Jr., Sorokin Y, Varner M, Wapner R, Caritis S, Iams J, Carpenter M, Peaceman A, Mercer B, Sciscione A, Rouse DJ, et al. Omega-3 Fatty Acid Supplementation to Prevent Recurrent Preterm Birth: A Randomized Controlled Trial. Obstet Gynecol 2010;115:2.1:234-42. Biggio J Jr, Chapman V, Neely C, Cliver S, Rouse DJ. Fetal Anomalies in Obese Women: The Contribution of Diabetes. Obstet Gynecol 2010;115:2.1:290-6. Contag SA, Clifton RG, Bloom SL, Spong CY, Varner MW, Rouse DJ, et al. Neonatal Outcomes and Operative Vaginal Delivery Versus Cesarean Delivery. Am J Perinatol 2010;27:493-9. Refuerzo JS, Momirova V, Peaceman AM, Sciscione A, Rouse DJ, et al. Neonatal Outcomes in Twin Pregnancies Delivered Moderately Preterm, Late Preterm, and Term .Am J Perinatol 2010;27:537-42. Schatz M, Dombrowski MP, Wise R, Lai Y, Landon M, Newman RB, Rouse DJ, et al. The relationship of asthma-specific quality of life during pregnancy to subsequent asthma and perinatal morbidity. J Asthma 2010; 47:46-50. Moldenhauer JS, Lai Y, Schatz M, Wise R, Landon MB, Newman RB, Rouse DJ, et al. Influence of maternal asthma and asthma severity on newborn morphometry. J Asthma. 2010 Mar; 47(2):145-9. Sorokin Y, Romero R, Mele L, Wapner RJ, Iams JD, Dudley DJ, Spong CY, Peaceman AM, Leveno KJ, Harper M, Caritis SN, Miodovnik M, Mercer BM, Thorp JM, O’Sullivan MJ, Ramin SM, Carpenter MW, Rouse DJ, Sibai B. Maternal Serum Interleukin-6, C-Reactive Protein, and Matrix Metalloproteinase-9 Concentrations as Risk Factors for Preterm Birth <32 Weeks and Adverse Neonatal Outcomes. Am J Perinatol 2010;27:631-40. 104
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Hashima JN, Lai Y, Wapner RJ, Sorokin Y, Dudley DJ, Peaceman A, Spong CY, Iams JD, Leveno KJ, Harper M, Caritis SN, Varner M, Miodovnik M, Mercer BM, Thorp JM, O’Sullivan MJ, Ramin SM, Carpenter M, Rouse DJ, Sibai B. The effect of maternal body mass index on neonatal outcome in women receiving a single course of antenatal corticosteroids. Am J Obstet Gynecol 2010;202:263.e1-5. Ramirez MM, Gilbert S, Landon MB, Rouse DJ, et al. Mode of Delivery in Women with Antepartum Fetal Death and Prior Cesarean Delivery. Am J Perinatol 2010. PMID: 20486068. Bakhshi T, Landon MB, Lai Y, Spong CY, Rouse DJ, et al. Maternal and Neonatal Outcomes of Repeat Cesarean Delivery in Women with a Prior Classical versus Low Transverse Uterine Incision. Am J Perinatol 2010. PMID: 20458666. Durnwald CP, Momirova V, Rouse DJ, et al. Second trimester cervical length and risk of preterm birth in women with twin gestations treated with 17-alpha hydroxyprogesterone caproate. J Matern Fetal Neonatal Med 2010. PMID: 20441408.
Saleem S, Rouse DJ, et al. Chlorhexidine vaginal and infant wipes to reduce perinatal mortality and morbidity: a randomized controlled trial. Obstet Gynecol. 2010;115:1225-32. Wylie BJ, Gilbert S, Landon MB, Spong CY, Rouse DJ, et al. Comparison of transverse and vertical skin incision for emergency cesarean delivery. Obstet Gynecol. 2010;115:1134-40. Rouse DJ. Magnesium sulfate for the prevention of cerebral palsy. Am J Obstet Gynecol 2009; 200: 610-612.
BOOKS AND BOOK CHAPTERS Tita AN, Rouse DJ. Obstetric Management of Labor and Vaginal Delivery. In: Chestnut DH, ed. Obstetric Anesthesia: Principles and Practice, 4th edition. Philadelphia: Mosby, 2009. Figueroa D, Rouse DJ. Location, Mode of Delivery and Intrapartum Issues for the Preterm Gestation. In: Berghella V, ed. Preterm Birth: Prevention and Management. Philadelphia: WileyBlackwell, 2010. Rouse DJ, Prevention of Cerebral Palsy. In: Queenan JT, Hobbins JC, and Spong CY, eds. Protocols for High-Risk Pregnancies, 5th edition. Hoboken: Wiley-Blackwell, 2010. Hauth JC, Cunningham FG, Rouse DJ. Use of Magnesium in Obstetrics. ACOG Update (Audio) 2009; 34: #7. Rouse, DJ. Editor, Williams Obstetrics, 23rd edition. McGraw-Hill, 2009.
EDITORIALS Rouse DJ, Hirtz D, Thom E. Reply to Mittendorf and Pryde. N Engl J Med 2009; 360: 190.
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Clark EA, Mele L, Wapner RJ, Spong CY, Sorokin Y, Peaceman A, Iams JD, Leveno KJ, Harper M, Caritis SN, Miodovnik M, Mercer BM, Thorp JM, Ramin SM, Carpenter M, Rouse DJ. Association of fetal inflammation and coagulation pathway gene polymorphisms with neurodevelopmental delay at age 2 years. Am J Obstet Gynecol 2010;83.e1-83.e10.
DIVISION OF UROGYNECOLOGY AND RECONSTRUCTIVE PELVIC SURGERY
MISSION The Division of Urogynecology and Reconstructive Pelvic Surgery (URPS) is also known as the Center for Women’s Pelvic Medicine and Reconstructive Surgery. It is a tertiary care center whose faculty are subspecialty fellowship-trained in Female Pelvic Medicine and Reconstructive Surgery; thus they have expertise in the diagnosis and treatment of pelvic floor disorders such as urinary incontinence, pelvic organ prolapse, defecatory dysfunction, interstitial cystitis, and fistulas. The mission of the Division of URPS is to: 1. Provide diagnosis and therapy for women with voiding and bowel dysfunction and
abnormalities of the pelvic floor
2. Serve as a referral source of experts for reproductive tract anomalies e.g. Mullerian
agenesis, minimally invasive reconstructive surgery including robotics, sacral stimulators
for chronic urge incontinence and urinary retention, urethral injection materials and
transvaginal systems for prolapse repair
Urogynecology & Reconstructive Pelvic Surgery
3. Provide education and training for the public, students, post graduate trainees and fellows
in urogynecology
4. Advance the research and science of urogynecologic and pelvic floor conditions 5. Outreach to those with devasting urinary fistulas in underserved areas of the world The main office location is at 695 Eddy Street with outreach offices at the Medical Office Buildings at South County Commons in Wakefield, East Greenwich and Woonsocket, RI.
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FACULTY–PHYSICIAN Deborah L. Myers, MD, FACOG, Division Director MD: State University of New York at Stony Brook Medical-Surgical Internship: Rhode Island Hospital Ob/Gyn Residency: Women & Infants Hospital of Rhode Island Fellowship: University of Connecticut Dr. Myers joined the Division of Urogynecology and Reconstructive Pelvic Surgery in 1992. She is board certified in Obstetrics and Gynecology and a fellow of ACOG. As Division Director, Dr. Myers leads the Division in its continued mission of patient care, education and research. Dr. Myers was promoted to Professor of Obstetrics and Gynecology in July 2009. Dr. Myers has particular expertise in the condition of interstitial cystitis. She oversees the RI Network for Pelvic Floor Disorders providers and meetings. She is the Medical Director of The Program in Women’s Physical Therapy. Dr. Myers serves on various hospital committees and several search committees for new faculty. She is a member of the Women’s Health Council of RI. Under her guidance, the Division has grown in faculty, space, clinical services and research. The Division now has its own urogynecologic research coordinator and research assistant, thus growing the Divisions’ ability to participate in multi-centered trials. Dr. Myers is the site PI for the BRIDGES trial – Bringing simple urge incontinence diagnosis and treatment to providers.
shop-based learning. Dr. Myers received teachers an excellence in teaching award for Undergraduate Education. Nationally, Dr. Myers is the President-elect of the American Urogynecologic Society (AUGS), chairs the AUGS governance task force and is board of director liaison for the Health Policy committee. Dr. Myers continues to serve on the Subcommittee on Urogynecology of the Committee on Gynecologic Practice of ACOG, and as an oral examiner for the American Board of Obstetrics and Gynecology. For the NIH / NICCD, she continues as a member of the Data and Safety Monitoring Board for the Urinary Incontinence Treatment Network and the Advisory Board for the Pelvic Floor Disorders Network. She continues to serve as a reviewer for national journals. Dr. Myers continues to lecture both nationally and locally. She was the course director for the Women & Infants conference entitled Pelvic Floor Disorders: The Team Approach held March 2010. She also lectured at 42nd Annual Matt Weis Symposium, at St John’s Mercy Medical Center, in St Louis MO. She presented an “Update on Neuromodulation” and “Obesity and the Pelvic Floor.”
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Dr. Myers’ teaching efforts at Women & Infants Hospital of Rhode Island are primarily work-
Charles R. Rardin, MD, FACOG MD: University of Rochester Residency: Beth Israel Deaconess Hospital Fellowship: Mount Auburn Hospital, Harvard Medical School Affiliated Hospitals Dr. Rardin joined the Division of Urogynecology and Reconstructive Pelvic Surgery in 2003. He is an Assistant Professor of Obstetrics and Gynecology. He is board certified in Obstetrics and Gynecology and a fellow of ACOG. He is the Director of the fellowship In Female Pelvic Medicine and Reconstructive Surgery (FPM&RS). Dr Rardin remains the leader in endoscopic surgery for the fellowship; he oversees the minimally invasive, laparoscopic and robotic training for the fellows. He continues to be the leader in Rhode Island and Southeastern New England for robotically-assisted pelvic reconstructive surgery, including sacral colpopexy for advanced pelvic organ prolapse. He serves on the Women and Infants Hospital Resident Evaluation Committee, Surgical Services Council, and Quality Council, and on the Robotic Surgical Services Steering Committee. Dr. Rardin’s research continues to evaluate prenatal risk factors for development of perineal trauma during childbirth, and the use of peripheral neuromodulation for voiding dysfunction and bladder overactivity. Dr Rardin is the Rhode Island site PI for a multi-centered surgical trial –SECURiTy, evaluating different sling devices for incontinence. He remains a reviewer for
Urogynecology & Reconstructive Pelvic Surgery
several journals. Dr Rardin’s teaching skills continue to be recognized. Over this past year he received the Women and Infants’ Hospital Excellence in Teaching Award, and Top Full-Time Faculty Teacher of the Year in both Undergraduate Medical Education and Resident Medical Education. Dr. Rardin serves on the Postgraduate Referral Committee at Alpert Medical School of Brown University, and serves as Advisor for medical students seeking residency in OB/Gyn. He continues to give grand rounds lectures locally and nationally. His presentations have involved roundtable discussions and hands – on – cadaver courses on laparoscopic (AAGL) and minimally invasive techniques. He is the Program Chair of the AUGS Female Pelvic Medicine for the Office-Based Provider Course, and the Program Chair for AAGL Postgraduate Course entitled “When Laparoscopy is Not Enough”. He will be serving as faculty for the upcoming AUGS Postgraduate Course “Masters of Surgery.” Nationally, Dr. Rardin continues to serve as website editor and director of the Information Technology Sub–committee on of the Public Relations Committee of the American Urogynecology Society. He is now on the program committee for AUGS. For the American Association of Gynecologic Laparoscopists, he serves the Publication Committee and its Video Review committee for the scientific program. He is also on the Education Committee of the Society of Gynecologic Surgeons. At the Annual Clinical Meeting of the American College of Obstetricians & Gynecologists, he presented the clinical seminar “Innovations in Pelvic Surgery: Old Standards vs. Kit-based Newcomers”. He speaks regularly on the indications and complications, and medicolegal implications for the use of mesh on pelvic reconstructive surgery 108
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Vivian W. Sung, MD, MPH MD: Tufts University School of Medicine Residency: Magee-Women’s Hospital / University of Pittsburgh Medical Center Fellowship: Women & Infants Hospital of Rhode Island/ Brown Medical School Dr. Sung joined the Division of Urogynecology and Reconstructive Pelvic Surgery in 2006. She is board certified in Obstetrics and Gynecology and a fellow of ACOG. Dr. Sung is currently an Assistant Professor of Obstetrics and Gynecology. She completed a dual fellowship in Female Pelvic Medicine and Reconstructive Pelvic Surgery and the John Evrard Fellowship in Epidemiology and Clinical Trials at Women and Infants Hospital in 2006, and transitioned off of the NICHD Women’s Reproductive Health Research (K 12 WRHR) program in 2009. Her research is now supported by a K23 career development award through the NICHD (20092014) and an American Urogynecologic Society Foundation Grant (2008-2010), and is focused on patient-reported outcomes for female pelvic floor disorders. She is site Co-investigator as well as a member of the Steering Committee and Executive Committee for the BRIDGES study, a multi-center randomized trial and site PI for the Informed Consent Evaluation project, a multicenter prospective cohort study. Her research skills and achievements are nationally recognized. She served as served as Co-Chair for the Society of Gynecologic Surgeons Systematic Review Writing Group from 2006-2009. Dr Sung is now the Chair for the Research Committee of the Society of Gynecologic Surgeons and a member of the Research Committee for the American Urogynecologic Society. She serves on the Senior Advisory Board for the Fellow’s Pelvic Research Network of the Society of Gynecologic Surgeons and is on the Board of Direcand serves as the Division of Urogynecology Research Director. She oversees the Division’s research team, which includes a research nurse coordinator, 1-2 research assistants, and 1 research intern at any given time with numerous ongoing multi-center studies. Dr. Sung remains involved in teaching and mentorship and is the mentor for many resident research projects. B. Star Hampton, MD, FACOG MD: Mount Sinai School of Medicine Residency: New York University School of Medicine Fellowship: New York University School of Medicine Dr. Hampton joined the Division of Urogynecology and Reconstructive Pelvic Surgery in 2006. She is board certified in Obstetrics and Gynecology and a fellow of ACOG. She is currently Assistant Professor of Obstetrics and Gynecology at Brown Medical School. Dr Hampton’s primary academic focus is education. Dr. Hampton is the Director of the Core Clerkship in Obstetrics and Gynecology at Warren Alpert School of Medicine of Brown University and remains a small group leader for Biomed 351 Human Reproduction, Growth and Development Pathophysiology. Her teaching expertise is sought after. This past year she presented the “Mentoring” seminar at the Clinical Faculty Teaching Workshop, Alpert Medical School. She presented a roundtable at the National APGO Faculty Development Seminar “Students teaching students: covering APGO Educational Objectives during the Ob/Gyn clerkship”. Dr. (continued)
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tors for the National Association for Continence. She is highly productive on a research level
Hampton was awarded the Dean’s Excellence in Teaching Award for her teaching in the Ob/Gyn Core Clerkship, and had the honor to be elected Faculty Marshall for the Alpert Medical School Commencement by the graduating class. She received Excellence in Teaching Awards for both undergraduate and resident education, as well as the Full-time Faculty award from Chief Residents. She completed the APGO Educational Scholar and Leader program. Dr Hampton serves on the Education Council and was co-leader of the Parental Leave Task Force at Women and Infants. Dr. Hampton was elected to and currently serves on the Postgraduate Referral Committee for Alpert Medical School. She was elected to and is a member of the Education Committee of the American Urogynecologic Society. Dr. Hampton’s recent research has been centered in education. She completed her project “Using interactive computer modules with dynamic animation for individual-based learning of female pelvic anatomy and female pelvic floor dysfunction” which led to two publications. Within her subspecialty of urogynecology, she has presented a roundtable discussion on New Approaches to Pelvic Floor Repair as well as a Clinical Seminar on Innovation in Pelvic Surgery at the ACOG annual meeting. She presented on Stress Urinary Incontinence at the RI Network for PFDs conference at Women and Infants Hospital, and gave grand rounds on Urinary Incontinence at Backus Hospital. She has collaborated with radiology on MRI imaging of the pelvic floor which led to a publication “Imaging pelvic floor disorders: trend towards comprehensive MR imaging” in the American Journal of Roentgenology. She is an editorial reviewer for International Urogynecology Journal and European Journal of Obstetrics and Gynecology and
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Reproductive Biology. Cassandra L. Carberry MD MS MD: University of Texas Health Science Center at San Antonio School of Medicine Residency: New York University School of Medicine Fellowship: New York University School of Medicine Master of Science: New York University School of Medicine Dr. Carberry joined the Division of Urogynecology and Reconstructive Pelvic Surgery in 2009. She is board certified in Obstetrics and Gynecology. Dr Carberry is Clinical Assistant Professor of Obstetrics and Gynecology. She completed her fellowship in Female Pelvic Medicine and Reconstructive Surgery in 2009 at New York University School of Medicine. While in fellowship she also enrolled in a Master of Science Degree program, and in May 2010 was awarded a Master of Science in Clinical Investigation, completing her thesis on “Desire for Information and Decisionmaking in Women with Pelvic Floor Disorders.” Her academic focus is patient outcomes. As a fellow, she was active in the Fellows’ Pelvic Research Network (sponsored by the Society of Gynecologic Surgeons), gaining valuable experience in conducting multi-center clinical research and co-authoring publications. Since completing fellowship, she has become an active member of the Systematic Review Group of The Society of Gynecologic Surgeons. She is an editorial reviewer for the Journal of Sexual Medicine. Dr. Carberry is Course Leader, for ObG-492, Clinical Urogynecology and Pelvic Reconstructive Surgery, MS4 Elective, for Alpert Medical School of Brown University. She also oversees men110
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tors, educates and develops curricula for all outside residents rotating from Family Practice, Internal Medicine, and Women’s Health, fellows from Women’s Gastroenterology and Geriatrics, as well as OB/GYN residents from other hospitals interested in fellowship in Female Pelvic and Reconstructive Surgery. She is a committed teacher, regularly precepting and providing lectures for third year medical students, as well as mentoring OB/GYN residents. She received recognition for Excellence in Teaching for the ObG-490 Core Clerkship in 2010. She has given Grand Rounds at various hospitals in Southern New England. Dr Carberry is the Division’s outreach point person for the northern RI region seeing patients at the Woonsocket Medical Office Building. She is interested in expanding clinical care as well as community outreach and education.
NURSE PRACTITIONER Sarah M Collins, MSN, APRN-BC, completed her Masters in Nursing / Nurse Practitioner degree at Simmons College in Boston, MA. She attended undergraduate study at Bridgewater State College in Bridgewater, MA and earned a BS in Psychology. She joined the Division in December 2008. She has expertise in non-surgical management of urinary incontinence, pelvic prolapse, and interstitial cystitis. Prior to her joining the Division, Sarah was a Nurse practitioner at the Beth Israel Deaconess Medical Center – Joslin Center in Needham, MA. Sarah has had experience in education as she was Assistant Professor of Nursing at the Caritas Laboure College in Boston MA. She has had expertise in alternative teaching techniques using video and simulation. coordinator at the Boston Medical Center, Androgen Clinical Research Unit in Boston from 2005-2006. As natural progression, she is research personnel of the Division’s BRIDGES trial. She also is a member of the National Association of Nurse Practitioners in Women’s Health, American Urogynecolologic Society, International Pelvic Pain Society, Interstitial Cystitis Association and Interstitial Cystitis Network.
CLINICAL ACTIVITY Referrals to the Division come from over 500 physicians’ offices. The majority of patients seen at the Division of Urogynecology and Reconstructive Pelvic Surgery are by referral from colleagues over a wide geographic area, principally, RI and Southern Massachusetts. The increased demand for clinical services has led to the Division’s growth. Dr Cassandra Carberry joined the faculty in August 2009 and Dr Kyle Wohlrab will join in July 2010. Dr Wohlrab completed his fellowship in FPM&RS at Women & Infants and will be active in resident teaching and robotics. With the increase in faculty and research, the Division’s clinical area underwent renovation to increase exam rooms and incorporate research offices and research clinical space. Academic offices are located at 45 Willard. Patients are sent for diagnosis and definitive therapy by the Division’s attending physicians, with surgery conducted at Women & Infants Hospital of Rhode Island. Particular effort is made to maintain the referring physician’s special relationship with the patient as an integral part of the collaborative therapeutic decision. (continued)
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Sarah also has research experience as she was a research nurse practitioner/ clinical research
The Division has had office hours at the Women & Infants Hospital of Rhode Island South County Commons offsite; services have expanded to the East Greenwich and Woonsocket Medical Office Buildings. Future outreach is planned into Eastern Connecticut and Massachusetts to ensure that women and their providers have convenient access to tertiary urogynecologic services. The basic philosophy of the Division is to discuss all means of therapy (conservative and surgical) and to tailor therapy individually. A full range of therapeutic modalities is offered, including exercise programs, behavior modification, vaginal devices, pharmacological therapy as well as surgery. As evidence of its commitment to a broad base of therapeutic options, the Division’s oversight of the physical therapy department for pelvic floor musculature rehabilitation therapy has led to increased growth. Providers from not only the local area, but also the New England region, refer to the division’s pelvic rehabilitation services thus demonstrating an increased need for this type of service. Fiscal Year
2005
2006
2007
2008
2009
Outpatient surgery
142
172
213
234
285
Inpatient surgery
207
182
239
261
249
Urodynamics
975
989
1257
1101
1167
New patient consults
777
787
1155
1148
1211
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The faculty at the Division keeps current with the use of graft and synthetic materials for reconstruction, mid urethral retropubic sling tapes and transoburator tapes, mini – slings, urethral injection materials, placement of sacral stimulators for neuromodulation and minimally invasive/ laparoscopic techniques and robotics. Although urinary incontinence comprises the preponderance of pelvic floor dysfunction, to a lesser frequency, but equally important, pelvic floor dysfunction may involve the lower intestinal tract. Appropriate diagnosis and management of rectal abnormalities are pursued with collaboration of the Women’s Gastroenterology service at Women & Infants Hospital of Rhode Island and with Colorectal Surgery services at the RI Hospital and Miriam Hospital. Patients with rectal compartment abnormalities are studied with ultrasound, anal manometry, and pelvic nerve conduction studies. The increased recognition of the utility of pelvic floor MRI to assist in evaluation of complex pelvic floor disorders has also led to increased demand for this imaging study from the Department of Radiology. The Rhode Island Network for Pelvic Floor Disorders has been established under Women & Infants Hospital launched by a successful CME conference held March 2010. The conference had both educational sessions for patients and providers, showcasing the interdisciplinary pelvic floor network. The RI Network for PFDs enhances providers’ ability to evaluate, diagnose and treat women with complex pelvic floor disorders. Regular monthly meetings continue amongst the providers for discussion of complex patients. All related disciplines (urogynecology, gastrointestinal, radiology, female urology, physical therapy and colo-rectal) participate in the monthly meetings.
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EDUCATION The educational activities of the staff of the Division of U&RPS are diverse and deeply involved on a number of fronts – the public, medical students, residency training, fellowship and colleagues. Teaching to the lay public is supported by participation and efforts of the members of the Division staff and the public relations staff of the hospital. Locally, faculty have presented at Women and Infants’ Patient Information sessions, presented to local senior groups, and appeared in newspaper articles, and radio and television spots to provide information on pelvic muscle disorders. This awareness has led to an increased consciousness in the lay community and increased demand for formalized evaluation. Education efforts at Warren Alpert Medical School of Brown University occur at various levels. The Division of Urogynecology faculty teach 2nd year students during the Human Reproduction Growth and Development section of the Integrated Medical Sciences Course on campus. The faculty and fellows in the Division serve as preceptors for the 3rd year medical students during their core clerkship in Ob/ Gyn. As part of the core curriculum in Ob/Gyn the third year medical students are taught an appreciation of the differential diagnosis of urinary incontinence. An elective for fourth year students in pelvic surgery/ urogynecology is offered to the students at Brown as well as students from other medical schools.
hensive lectures in Urogynecology and Reconstructive Pelvic Surgery is part of the residency core curriculum, given on a recurring two-year cycle. Chief residents (PGY4) rotate through the division for 7–8 weeks. During that time they participate in all the activities of the Division, in the consultation room, the operating room as well as in the diagnostic laboratory. Here they receive hands–on instruction in evaluation, management and longitudinal postoperative follow– up. Residents at the PGY-3 level from other Ob/ Gyn programs do electives in urogynecology often leading them to pursue and procure fellowship positions. Second year resident rotation in the division is 2 ½ days per week with exposure to both office and the operating room. The PGY2 and PGY4 residents also participate in the Division’s “fellow’s clinic” one half day per month giving them direct patient care responsibilities in diagnosis and management of urogynecologic patients. The faculty of the Division of Urogynecology and Pelvic Reconstructive Surgery run and participate in various “hands–on”/skills workshops. As part of the PGY-1 orientation week- our faculty participate in the “surgical skills” lab. During the third year of residency, the faculty and fellows under the direction of Dr. Myers, provide a three hour educational session on teaching pelvic anatomy using clay models. This novel teaching lab has been shown to be effective and fun in learning pelvic anatomy. The faculty and fellows also work under the direction of Diane Angelini, PhD, Program in Midwifery, in a “hands on” training session for 3rd and 4th degree (continued)
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Resident training is very much an active part of the teaching portfolio. A series of compre-
episiotomy repair for the incoming 3rd year residents and a refresher session for 4th year residents using a beef–tongue model. In the spring, a fresh frozen cadaver workshop, directed at repair of urological and intestinal injuries (PGY-3) and an anatomy teaching of the human female pelvis is provided (PGY-4) residents. Under the direction of Drs. Hampton and Rardin, faculty and fellows serve as preceptors. Dr Rardin participates in the endoscopy lab workshops. Residents each year rate these workshops highly. Many other specialties under the direction of Dr Carberry rotate through the Division, gleaning experience and exposure to problems of urinary incontinence and pelvic prolapse: residents in Women’s Health and fellows in Geriatric Medicine from RI Hospital, Family Medicine and Internal Medicine residents from Memorial Hospital. A Fellowship training experience is provided for the fellows in the Division of Gastroenterology. To support the efforts of the Division in clinical care, teaching and research, a philanthropic campaign, the “Grateful Patient” was developed and implemented.
FELLOWSHIP TRAINING In 1998, the fellowship program in Female Pelvic Medicine and Pelvic Reconstructive Surgery was approved, and recertified in 2002, 2005 and most recently 2010. There are currently 38 certified fellowship programs in Female Pelvic Medicine and Reconstructive Pelvic Surgery. The
Urogynecology & Reconstructive Pelvic Surgery
Division has graduated 10 fellows: Peter Rosenblatt, MD (1995) Assistant Professor of Ob/Gyn, Director Division of Urogynecology, Mount Auburn Hospital, Harvard Medical School Affiliated Hospitals, Cambridge, MA. Christine LaSala, MD (1997) Clinical Associate Professor of Ob/Gyn, Director of the Division of Urogynecology, Hartford Hospital, University of Connecticut, Hartford, CT. Lily Arya, MD (2000) Assistant Professor of Ob/Gyn, Director of the Division of Urogynecology and the Fellowship in Female Pelvic Medicine & Reconstructive Surgery, University of Pennsylvania, Philadelphia, PA. Jeffrey Clemons MD, LTC, MC (2002) Chief, Urogynecology and Pelvic Reconstructive Surgery, Chief, Gynecology Madigan Army Medical Center, Tacoma, WA. Vivian Aguilar, MD (2003) Director, Fellowship in Urogynecology and Reconstructive Pelvic Surgery, Department of Ob/Gyn, Cleveland Clinic Florida, Weston, FL. Eric Sokol, MD (2005) Assistant Professor of Ob/Gyn, Co–Director of the Division of Urogynecology and Reconstructive Pelvic Surgery, Stanford University, Palo Alto, CA.
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Vivian W Sung, MD, MPH (2006) Assistant Professor of Ob Gyn, Leader in Research Training, Division of Urogynecology and Reconstructive Pelvic Surgery, Brown Medical School, Providence, RI. Renee Ward, MD (2005–2008), Assistant Professor of Ob/Gyn, Division of Gynecology, Vanderbilt University, Nashville TN. Elisabeth A. Erekson, MD (2006–2009), Assistant Professor of Ob/Gyn, Yale University, New Haven CT. Kyle J. Wohlrab, MD (2007-2010), Clinical Assistant Professor of Ob/Gyn, Division of Urogynecology and Reconstructive Pelvic Surgery, Alpert Medical School of Brown University, Providence, RI. Blair B. Washington, MD, MHA (2008-2011) will be the Division’s 3rd year fellow in Female Pelvic Medicine & Reconstructive Surgery. Dr. Washington completed her MD and MHA at the University of Washington School of Medicine (2002) and then a general surgery internship at Howard University (2003). She completed her residency in Obstetrics and Gynecology at The Stamford Hospital, Columbia University College of Physicians and Surgeons (2008). She has been recognized as an effective educator and received the graduate medical education Fellow Excellence in Teaching Award in June 2010. Dr. Washington also serves as a preceptor for the students in the OB/Gyn core clerkship, preceptor for Gyn morning report, and a preceptor for research, Dr. Washington was awarded Best Manuscript at the 2009 meeting of the American Urogynecologic Society for her evaluation of the ambulatory costs of female pelvic floor disorders. She has also published this year on the association between prolapse and defecatory dysfunction, the association between obesity and prolapse and the costs of ambulatory care related to female pelvic floor disorders in the United States. Dr. Washington’s research interests focus on access to health care. Peter C Jeppson, MD (2010-2013) will be the Division’s 1st year fellow in Female Pelvic Medicine & Reconstructive Surgery. Dr Jeppson graduated from Saint Louis University Health Sciences Center, Saint Louis, MO in 2006 and completed residency in Ob/Gyn at Case Western Reserve University MetroHealth Medical Center/Cleveland Clinic in 2010, where he was selected to be the chief administrative resident. During residency Dr Jeppson was recognized for his teaching efforts – he was awarded the Bayer HealthCare Pharmaceuticals Best PGY2 Ob/ Gyn Teaching Resident. In 2009 was awarded the Arnold P. Gold Foundation, an award for humanism and excellence in teaching. He has a long track record of teaching at all levels- he was an arithmetic and reading teacher for elementary students, as well as college level chemistry teaching assistant and medical student anatomy instructor. Dr Jeppson has traveled on outreach missions to Guatemala. His research interests have been in pelvic pain syndromes and robotic outcomes. (continued)
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the division’s educational workshops and the department’s endoscopy course. With regard to
Nicole B. Korbly, MD (2010-2013) will be the Division’s 1st year fellow in Female Pelvic Medicine & Reconstructive Surgery. Dr Korbly graduated AOA from University of Massachusetts Medical School, Worcester MA in 2006. She completed her OB/Gyn residency at Women and Infants Hospital (2010). Dr Korbly has a strong interest in research. Prior to medical school, Dr Korbly worked as a research coordinator at the Massachusetts General Hospital in the Department of Psychiatry. She also spent a summer (1998) at the NIH as a research coordinator in the Department of Child Psychiatry. During residency she served as the resident representative for WIH IRB. Her research pursuits in the field of urogynecology have been investigating the effect of pelvic floor physical therapy on QOL, sexual function and body image in women with pelvic floor disorders.
RESEARCH/PUBLICATIONS The Division continues to make yearly presentations at the AUGS (American Urogynecologic Society) scientific meetings since 1997 and at the SGS (Society of Gynecologic Surgeons) annual meetings since 2000. The Division’s leader in research, Dr Vivian W Sung MD MPH, urogynecologic research coordinator, Ann Meers, RN and research assistant, Felisha Marques, all enhance the Divisions’ ability to participate in national multi-centered trials and perform its own larger prospective studies. This establishment of research personnel is an investment in the future of the Division’s research and reputation.
Urogynecology & Reconstructive Pelvic Surgery
Lowenstein L, Gamble T, Sanses T, Van Raalte H, Carberry CL, Jakus S, Kambiss S, McAchran S, Pham T, Aschkenazi S, Hoskey K, Kenton K for the Fellows’ Pelvic Research Network. Sexual Function is Related to Body Image Perception in Women with Pelvic Organ Prolapse. J Sex Med 2009 Aug;6(8):2286-91. Erekson EA, Weitzen S, Sung VW, Raker C, Myers DL. Socioeconomic indicators and hysterectomy status in the United States, 2004. J Reprod Med 2009 Sep;54(9):553-8. Sung VW, Hampton BS. Epidemiology of pelvic floor dysfunction. Obstet Gynecol Clin North Am, 2009;Sep 36(3):421-43. Sung VW, Raker CA, Myers DL, Clark MA. Ambulatory related care related to female pelvic floor disorders in the United States 1995- 2006. Am J Obstet Gynecol. 2009 Nov; 201(5):508. PMCID: PMC2784092. Sung VW, Joo K, Marques F, Myers DL. Patient-reported outcomes after combined surgery for pelvic floor disorders in older compared to younger women. Am J Obstet Gynecol. 2009 Nov;201(5):534. PMCID: PMC2783851. Hampton BS, Erekson EA, “Antibiotic prophylaxis for short-term post-operative transurethral Foley catheter use in women after sub-urethral sling,” J Pelv Med Surg, Nov/Dec 2009; 15:427-443. 116
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Hampton BS, Ward RM, Idrissa A, “Attitudes and expectations of women undergoing vaginal fistula repair in Niger,” J Pelv Med Surg, Nov/Dec 2009; 15:441-447. Lowenstein L, Gamble T, Sanses T, Van Raalte H, Carberry CL, Jakus S, Pham T, Nguyen A, Hoskey K, Kenton K. Changes in Sexual Function after Treatment for Prolapse Are Related to Improvement in Body Image Perception. J Sex Med. 2010 Feb;7(2 Pt 2):1023-8. Sung VW, Raker C, Myers DL, Clark MA. Treatment decision- making and information -seeking preferences in women with pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct. Int Urogynecol J Pelvic Floor Dysfunct. 2010 Apr 28. [Epub ahead of print] Washington BB, Erekson EA, Kassis NC, Myers DL. The association between obesity and stage II or greater prolapse. Am J Obstet Gynecol. 2010 May;202(5):503.e1-4. Woodfield CA, Krishnamoorthy S, Hampton BS, Brody JM, “Imaging pelvic floor disorders: trend towards comprehensive MR imaging,” AJR Am J Roentgenol. 2010 Jun;194(6):1640-9. Review. Hampton BS, Sung VW. Improving medical student knowledge of female pelvic floor dysfunction and anatomy: a randomized trial. Am J Obstet Gynecol. 2010 Jun; 202(6):601.e1-8.
ACTIVE GRANTS
NIH-NICHD Patient-reported outcomes in functioning for female pelvic floor disorders Role: PI Career development award focused on developing and testing a comprehensive questionnaire for patient functioning in female pelvic floor disorders utilizing traditional and innovative survey methods and item response theory psychometrics. The questionnaire framework will be guided by the NIH-PROMIS framework and the patient perspective. Provides 75% protected time for research and career development. American Urogynecologic Society Foundation Grant (Sung, PI) 12/16/08-12/31/10 Application of the Patient-Reported Outcomes Measurement Information System (PROMIS) to Female Pelvic Floor Disorders Role: PI To determine the face and content validity of the National Institutes of Health PROMIS system and the feasibility and usability of computerized-adaptive testing for collecting patient-reported outcomes in women with urinary incontinence.
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K23HD060665-01 (Sung, PI) 6/15/09-6/15/14
BRIDGES (Bringing Simple Urge Incontinence Diagnosis and Treatment to Providers) (Brown, PI) Role: Site PI Myers, Co- PI Sung Multi-center study evaluating the effect of fesoterodine to placebo in the treatment of urge urinary incontinence. Informed Consent Process for Women Undergoing Surgery for Stress Incontinence (Rogers, PI) Role: Site PI Sung Multi-center study evaluating patient knowledge, understanding and recall of the surgical informed consent process before and after midurethral sling treatment for stress urinary incontinence. Foundation for Female Health Awareness 2009 - present SECURiTy; Role: site PI Rardin A randomized trial comparing the Tension-Free Vaginal Tape (TVT) procedure with the TVTSECUR for the surgical treatment of stress urinary incontinence.
AWARDS
Urogynecology & Reconstructive Pelvic Surgery
Washington BB, Raker C, Sung VW. Medicare Costs and Private Payer Charges for the Ambulatory Care of Female Pelvic Floor Disorders in 2006. (Oral Presentation) American Urogynecologic Society 30th Annual Clinical Meeting in Hollywood, FL. September 24th to 26th, 2009. Best Manuscript, American Urogynecologic Society Outstanding Science Award. Carson SA. “An Update on Female Sexual Response,” Pelvic Floor Disorders Conference, Women & Infants Hospital of Rhode Island, Providence, RI, March 13, 2010. Carson SA. “An Update on Female Sexual Dysfunction,” Grand Rounds, Massachusetts General Hospital, Boston MA, May 6, 2010. Carson SA. “Take Down the Heat of Hot Flashes,” Sisterhood meeting, Temple Sinai, Cranston RI, June 2, 2010.
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EMERGENCY OB/GYN Donna M. LaFontaine, MD, Director BA: Holy Cross College MD: University of Massachusetts Ob/Gyn Residency: Women & Infants Hospital of Rhode Island Dr. Donna Lafontaine is the Director of the Division of Emergency Obstetrics and Gynecology and a Clinical Assistant Professor at the Warren Alpert School of Medicine at Brown University. She came to the Triage Unit in 2003 and her professional goals include improving the quality of care as well as the efficiency of care in the OB/GYN Triage Unit. She coordinated efforts to start a Sexual Assault Nurse Examiner Program at Women and Infants, currently the only hospital in Rhode Island offering these resources to patients. Dr. LaFontaine participates in the teaching of medical students and residents and serves as preceptor for BioMed 331A (Ob/Gyn core clerkship). Dr. LaFontaine coordinates and directs the experience of the visiting residents from the RIH Emergency Medicine Residency and Kent Emergency Medicine Residency. Alfredo Gil, MD BS: Florida International University MD: Howard University College of Medicine Ob/Gyn Residency: Thomas Jefferson University Hospital Dr. Alfredo Gil, Clinical Assistant Professor if Obstetrics and Gynecology at Warren Alpert Medical School of Brown University, joined the Division of Emergency Obstetrics community faculty since 2004, and a private attending with a local practice, Dr. Gil brings an interest and expertise in minimally invasive gynecologic surgery and treatment of incontinence. He also continues as an active member of the Clinic Attending Service. Robyn Gray-Puleo, D.O. BA: Wheaton College MD: University of New England College of Osteopathic Medicine Ob/Gyn Residency: Christiana Care Health System Dr. Robyn Gray-Puleo has been a member of the Women & Infants physician staff since 2004 as a private attending and participant in the Clinic Attending Service. A Fellow of the American College of Obstetrics and Gynecology, she joined the Division of Emergency Obstetrics and Gynecology in August 2008. Her expertise is in general obstetrics and gynecology with an interest in pediatric and adolescent gynecology.
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and Gynecology as a full time attending in March 2010. A member of the Women & Infants
Moune Jabre-Raughley, MD BA: Boston University MD Boston University Ob/Gyn Residency: Women & Infants Hospital of Rhode Island Dr. Moune Jabre-Raughley graduated from residency in June 2009 and joined the staff of the Division of Emergency Obstetrics and Gynecology in July of the same year. Fluent in Arabic and French, Dr Jabre-Raughley has an interest in global health and international medicine. She is also a Fellow of the American College of Obstetrics and Gynecology. Martha Pizzarello, MD BA: Boston College MD: Georgetown University School of Medicine Ob/Gyn Residency: Tufts-New England Medical Center Dr. Martha Pizzarello, Clinical Assistant Professor of Obstetrics and Gynecology at Warren Alpert Medical School of Medicine at Brown University, serves as an attending physician in the Division of Emergency Obstetrics and Gynecology and participates in the Clinic Attending Service. A Fellow of the American College of Obstetrics and Gynecology, Dr. Pizzarello comes to Women & Infants Hospital of Rhode Island from the Vincent Obstetrics and Gynecology Service at Massachusetts General Hospital where she served as an Instructor at Harvard Medical School. Her interests and expertise are in general obstetrics, colposcopy and female sexual dysfunction. Brenda Roy, MD
Emergency Ob/Gyn
BS: Queen’s University, Ontario, Canada MD: University of Toronto, Ontario, Canada Ob/Gyn Residency: McGill University, Quebec, Canada Dr. Brenda Roy joined the Division of Emergency Obstetrics and Gynecology as a part time attending physician in September 2008. Trained in Canada, Dr. Roy has an interest in laparoscopic and robotic surgery, and is also involved in a training program with a local private physician to hone her surgical skills. She is appointed as a Clinical Assistant Professor of Obstetrics and Gynecology, Warren Alpert Medical School. Amy Laura Snyder, MD BA: University of Michigan MD: University of Connecticut Ob/Gyn Residency: University of Connecticut Health Center & Hartford Hospital Dr Amy Snyder, a Fellow of the American College of Obstetrics and Gynecology, comes to the division of Emergency Obstetrics and Gynecology from a private practice in West Hartford, CT. Certified through the American Institute for Ultrasound in Medicine, she is also an active participant in the clinic coverage system. 120
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Roxanne Vrees, MD BA: Brown University MD: Brown University Ob/Gyn Residency: Women & Infants Hospital of Rhode Island Dr. Roxanne Vrees came to the Division of Emergency Obstetrics and Gynecology as an attending in September 2008 after practicing with a local physician group since completing her residency. As a graduate of the Women & Infants residency program, Roxanne brings a keen understanding of the day to day activities of the residency and how to best integrate teaching into the hectic pace of an emergency room. She is an active participant in the Clinic Attending Service and member of the Medical Records Task Force. Emily White, MD BS: George Washington University MD: State University of NY at Brooklyn College of Medicine MPH: Columbia University Ob/Gyn Residency: Women & Infants Hospital of Rhode Island Dr. Emily White joined the Division of Emergency Obstetrics and Gynecology in October 2009 after working in private practice in New York for two years. A Fellow of the American College of Obstetricians and Gynecologists, Dr. White returns to Women and Infants with an interest in quality improvement and organizational efficiency. As a graduate of the residency program here, she brings an in-depth understanding of the role of residents in the Emergency/Triage area and will focus on improved efficiency in patient flow and documentation. Dr. White is also an active participant in the Clinic Attending Service.
the only division of this type in the nation. The primary goal is to provide acute care for obstetrical and gynecologic urgent and emergent problems, 24 hours each day, 7 days a week. The facilities include 12 exam rooms with capacity to care for obstetric and gynecologic patients. The increase in the number of attending physicians has had a major positive impact on the efficiency of care provided in the unit and has expanded the teaching opportunities to 24/7. The Emergency Ob/Gyn Unit provides teaching rotations in emergency obstetric and gynecologic care to residents and fellows from Kent Hospital Emergency Medicine Residency, Rhode Island Hospital Emergency Medicine Residency, and Rhode Island Pediatric Medicine Fellowship, as well as Brown medical students. Plans are underway to expand patient care space and to improve patient flow through the unit. The Triage unit provides state-of-the-art ultrasound equipment and collaborates with radiology for other needed radiologic procedures. The Triage unit works in collaboration with other hospital clinical care units including labor and delivery, antepartum units, operating room, and
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The Triage unit is the operating unit of the Division of Emergency Obstetrics and Gynecology,
in-patient gynecology floors. The triage team also facilitates follow-up for patients seen in the unit to their primary physicians. The Triage unit saw 30,006 in fiscal year 2007; 30,544 in fiscal year 2008; and 28,925 in fiscal year 2009. Recent initiatives include the introduction of Sepsis, Stroke, Chest Pain and DKA protocols, dedicated attending coverage 24/7, and the implementation of an Automatic Urine Reflux plan which has greatly reduced the number of patients returning with worsening uri-
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nary symptoms.
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NURSE MIDWIFERY MISSION To support the educational goals of Brown University medical students and obstetric residents at Women & Infants Hospital (WIH) of Rhode Island regarding basic knowledge and skill acquisition in both obstetric triage and low–risk intrapartum services. To augment the clinical services provided by obstetric residents within the Department of Ob/ Gyn by providing timely and expert care within the obstetric service, i.e., labor–delivery, operating room, obstetric triage and gestational diabetic clinic. To advance the academic preeminence of the Department of Ob/Gyn by participating in national and international presentations, as well as publications and research projects advancing the specialty of midwifery.
FACULTY Diane J. Angelini, EdD CNM FACNM FAAN, Director Clinical Associate Professor EdD: Boston University CNM: State University of New York at Downstate MSN: University of Pittsburgh BSN: Fitchburg State College Diane served as Director of both the midwifery practice and educational programs at LA County–USC for five years as well as the Director of Midwifery at Brigham and Women’s Hospital in her role as Nursing Administrator. She was Interim has edited two books and published numerous articles. She is Senior Editor for the Journal of Perinatal and Neonatal Nursing and Associate Editor, Journal Watch Women’s Health Journal. She is a reviewer for the Journal of Midwifery and Women’s Health and served as Educational Consultant for the same journal from 1998-2007. She is recertified as a Nurse Executive Advanced (NEA-BC). She was elected a Fellow to both the American College of Nurse Midwives and the American Academy of Nursing. She has 34 years midwifery experience.
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Director for the University of RI Nurse Midwifery Educational Program from 1993–1994. She
Elisabeth D. Howard, PhD, CNM Clinical Assistant Professor PhD: Vanderbilt University CNM: Yale University MSN: Yale University BA: William Smith College (New York) From 1985 to 1988, Liz worked as Information Coordinator, Counselor in Family Planning and Director of Family Health Education. From 1991 to 1995, she worked as a Nurse Midwife at Parkland Memorial Hospital in Texas, Martin Luther King, Jr. Family Clinic in Texas and Maternal Infant Care Project in Tennessee. From 1995 to June 2004, she served as Instructor and Midwifery Practice Director at Vanderbilt University School of Nursing in Nashville, Tennessee. Liz is a reviewer for the Journal of Midwifery and Women’s Health. She serves as the American College of Nurse-Midwives’ delegate for the National Quality Forum. Currently, she is special guest editor for the Journal of Perinatal and Neonatal Nursing’s forthcoming issue on perinatal bereavement. She has 19 years midwifery experience. Linda Hunter, EdD, CNM Clinical Assistant Professor EdD: University of Vermont CNM: University of RI MS: University or RI BS: University of RI; BA: Mohegan Community College From 1982 to 1995 Linda worked as an RN in the emergency room, labor and delivery and as a staff educator at WIH. Since receiving her master’s degree, she has worked in a private practice in New London Connecticut for 7 years and then joined the faculty practice of the University of Vermont. From 2002 to 2007, Linda worked in a hospital based nurse-midwifery practice and held faculty appointments in the College of Medicine the College of Nursing and Health Sciences, where she remains an Adjunct Instructor. She is a peer reviewer for both the Journal
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of Midwifery and Women’s Health and the Journal of Obstetric, Gynecologic, and Neonatal Nursing. She actively participated in the classroom and clinical education of nursing and medical students and has lectured extensively on a variety of women’s health topics. Linda has 15 years midwifery experience. Edie P. McConaughey, MSN, CNM Senior Clinical Teaching Associate MS: University of RI; CNM: University of RI BS: University of RI; BA: University of RI Edie worked at Women and Infants’ Hospital, prior to her midwifery experience, where she was responsible for nursing staff education for both Labor and Delivery and High Risk Antepartum Units. Her midwifery experience includes working in RI for both a large HMO OB/Gyn group and a private OB/Gyn practice for a total of seven years. In these settings, she was involved with the clinical education of both midwifery and medical students. Edie is a peer reviewer for the Journal of Midwifery and Women’s Health. She has 15 years midwifery experience. 124
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Janet E. Singer, MSN, CNM Senior Clinical Teaching Associate MSN: Yale University CNM: Yale University BSN: Columbia University BA: Harvard College For six years, Janet was a nurse midwife in private midwifery practice in the Greater Boston area, where she was involved in the education of midwifery and medical students, as well as family practice residents. Janet serves as President of the Board of the Abortion Access Project. She lectures widely on issues surrounding abortion care. She has worked for IPAS on a project providing Technical Assistance and Mentoring to hospitals interested in offering outpatient management of early pregnancy loss and/or abortion to their patients. As Senior Clinical Advisor to the Women’s Dignity Project, she has assisted in research on vesico-vaginal fistula in women from Tanzania. Janet has been appointed Assistant Core Clerkship Director of Midwifery Didactics at Women & Infants’ Hospital. Janet is a reviewer for the Journal of Midwifery and Women’s Health. She has 19 years midwifery experience. Linda Steinhardt, MS, CNM, FNP–C Senior Clinical Teaching Associate Post Master’s Certificate in Teaching. University of Pennsylvania MS: Pace University CNM: University of Medicine and Dentistry of New Jersey FNP–C: Pace University; BA: Bard College Linda was a Family Nurse Practitioner for nine years at St. Luke’s/Roosevelt Hospital and in the Student Health Services at the Fashion Institute of Technology in NYC. In 1991, she continued her education as a CNM. She has worked as a CNM at St. Luke’s/Roosevelt Hospital and the Bronx Municipal Hospital Center in New York City, and as faculty at UMDNJ/St. Mary Hospital Center Family Practice Residency program in New Jersey. For the three years prior to coming to Brown, Linda was in private practice as a CNM affiliated with St. Vincent’s Medical Center midwifery experience. Sylvia Ross, MSN, CNM MSN: University of Pennsylvania CNM: University of Pennsylvania BSN: University of New Hampshire Sylvia worked in the Midwifery section at WIH from 1993 to 1996 and then again recently joined the group in March of 2010. Currently, Sylvia is a PhD student at the University of Rhode Island. Her interest is in interprofessional clinical education. Since receiving her midwifery degree, Sylvia has been in private OB/GYN practice in Rhode Island and is currently on the faculty at Rhode Island College School of Nursing as an Assistant Professor. Sylvia has 16 years midwifery experience. (continued)
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in NYC. Linda coordinates the midwifery gestational diabetic (GDM) clinic. She has 20 years
CLINICAL ACTIVITIES Inpatient Service: Labor and Delivery Midwifery faculty provide clinical management, consultation and teaching in labor and delivery Monday through Friday. Consultation and supervision are provided for medical students and obstetric residents in the clinic management of labor and delivery on the low risk obstetric service. Midwifery faculty provide direct clinical services to women by sharing in the care of all women presenting in labor on the low–risk obstetric service. Inpatient Service: OR 1st Assist — C-Sections Two midwifery faculty are credentialed to function as first-assistants in the operating room for C-Sections. This expanded midwifery role provides for part time 1st assist coverage during the week (for assistance with primary and repeat cesarean sections). Two 4 hour sessions are covered weekly by midwives for 1st assist. Inpatient Service: Postpartum Rounds Starting in May 2010, midwifery faculty are now the attending provider, rounding on all clinic patients in the low-risk obstetric service, Monday – Friday. Ambulatory Service: Obstetric Triage Midwifery faculty staff the obstetric triage unit, caring for women who primarily present with obstetric complaints. They provide direct clinical care to pregnant women and provide clinical teaching to obstetric interns and Rhode Island Hospital (RIH) Emergency Room residents. They assist PGY–1 residents in the acquisition of various skills including: use of the microscope, sterile speculum and vaginal exams, fetal assessment, limited sonography (including amniotic fluid index, biophysical profile, biometry), Leopold’s maneuvers, and evaluation of women with preterm labor, bleeding, pre–eclampsia, post–term pregnancy, bleeding and intrauterine
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growth restriction as well as other obstetric complaints. Ambulatory Service: Gestational Diabetic (GDM) Clinic Every Tuesday afternoon, GDM clinic is staffed by one midwifery faculty member with Maternal Fetal Medicine (MFM) consultation available. This clinic is a referral clinic for antepartum GDM patients from Women & Infants Hospital and from Providence Health Centers. Midwives work collaboratively with MFM in this setting. MIDWIFERY PRODUCTIVITY STATISTICS FY 2008
FY 2009
FY 2010 (completed thru June 2010)
Births
334
334
265
OB Triage Visits
3334
3359
2162
1st Assist C-Sections
28
15
42
417
428
318
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507
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TEACHING RESPONSIBILITIES Medical Students The midwifery faculty assist in core clinical education for third year medical students from Brown Medical School. These students perform history and physical exams, and participate in labor and birth experiences under the guidance of the midwifery faculty. Simulations for episiotomy and laceration repair, mechanisms of labor and hand maneuvers for delivery to enhance skill acquisition are practiced while on the labor unit. This is in preparation for actual experiences with patients as well as to prepare for the OSCE skill stations at the end of the rotation in which the midwives participate as proctors. Six hours of lecture time are provided by the CNMs during the six–week rotation. Midwives are responsible for approximately 3–5 medical students per week on labor and delivery. OB/GYN Residents During the eight weeks the PGY-1 residents are on the low risk OB service, midwifery faculty assist them with labor management, birth experiences, procedural skills, use of local and pudendal anesthesia, episiotomy and laceration repair and verify accuracy of vaginal examinations. At the completion of approximately 30 births, each PGY-1 resident is assessed for competency with: hand maneuvers for delivery, episiotomy/laceration and repair and accuracy of vaginal examinations. They are assessed for competency with basic ultrasound skills as well as with selected clinical scenarios in the triage setting. Numerous educational workshops are held yearly for residents by the midwifery faculty. Midwifery faculty serve as primary consultants for the PGY-2 experiences during their labor and delivery rotation. Expanded suturing and clinical decision making skills are emphasized, along with a specific reading list.
MIDWIFERY / RESIDENT WORKSHOPS
The PGY-1 Resident Orientation is a full day program given to all PGY-1 interns at the beginning of residency. The content consists of intrapartum seminars and skill sessions addressing clinical dexterity and beginning level clinical management of pregnant women in labor and delivery. The skill and simulation sessions include: abdominal assessment, vaginal exams, rupture of membranes, prolapsed cord, use of fetal scalp electrode, intrauterine pressure catheter, amnioinfusion, electronic fetal monitoring, local anesthesia, cutting and repair of episiotomy/ lacerations, hand maneuvers for birth (including management of nuchal cord, meconium and shoulder dystocia), third stage management and postpartum hemorrhage. PGY–2 Advanced Skills Workshop An advanced clinical skills workshop for the PGY-2 residents is conducted each year. This advanced skills workshop covers a case based approach to fetal heart rate (FHR) monitoring (continued)
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and advanced interpretation of FHR strips, as well as clinical management of non–reassuring FHR tracings. The workshop also covers shoulder dystocia, postpartum hemorrhage, alternative birthing positions, and principles of effective clinical teaching in the birth setting. Clinically, midwives are available on labor and delivery to review labor management and clinical decision–making with PGY-2 residents. PGY–3 Workshop This advanced skills workshop is a collaborative effort between Midwifery and the Uro–Gyn Division under Dr. Deb Myers. A clinical simulation lab is set up to demonstrate repair of mediolateral episiotomy, as well as 3rd and 4th degree laceration repair. Didactic material on perineal anatomy and physiology is provided. PGY-4 Workshop for New Leaders This is a 2½ hour workshop focusing on leadership skills for chief residents. This workshop is guided by the SynecticsTM process of using creative problem solving techniques. Leadership scenarios are included in the workshop to role play leadership issues commonly encountered by chief residents in their leadership role. Follow-up on leadership aspects are reviewed with all new obstetric chief residents during their senior rotation as low-risk OB chief. RIH – ER Resident Workshop In collaboration with the RIH Emergency Department, the midwives have continued to develop and coordinate educational training experiences for the ED residents’ in managing selected obstetric emergencies. This year, the midwifery faculty will be providing a didactic and practicum training session for the ED interns focusing on pelvic exam techniques and specimen collection for selected obstetric and gynecology clinical scenarios. Using standardized patients, this session will also help prepare the ED interns for their upcoming clinical rotations at WIH.
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RESIDENT MENTORING PROGRAM PGY-1 Mentoring Program Each June, midwifery faculty assume the role of mentors for the incoming PGY-1 residents. Each new resident is assigned a midwife faculty person during the first year. The faculty meets with him/her on a regular basis tracking clinical experiences and adjustments to the resident role, especially while rotating on the low–risk obstetric service. Obstetric noon conferences for interns are coordinated through the midwifery faculty preceptor who assumes responsibility for assisting interns with noon conference planning and presentation skills.
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EDUCATIONAL ACTIVITIES Midwives are actively involved in multiple educational activities with medical student and resident education. These include the following: Diane J. Angelini: Resident Core Curriculum Lecture: “Management of Shoulder Dystocia” Core Clerkship Lecture: “Intrapartum I and II” Coordinator: PGY–3 Workshop Participating Workshop Faculty: PGY–1, PGY–3 Elisabeth D. Howard: Resident Core Curriculum Lecture: “First Stage Labor Management” Core Clerkship Lecture: “Intrapartum I and II” Core Clerkship Lecture: “Electronic Fetal Monitoring: The Basics” Coordinator: PGY–2 Workshop Participating Workshop Faculty: PGY–1, PGY–2, RIH ED Resident Workshop Linda A. Hunter: Resident Core Curriculum Lecture: “Analgesia and Anesthesia in Labor.” Core Clerkship Lecture “Intrapartum I and II” Core Clerkship Lecture “Electronic Fetal Monitoring: Basics” Coordinator: RIH ED Resident Workshop Participating Workshop Faculty: PGY-1, PGY-2, RIH ED Resident Workshop Credentialed 1st Assist C-Sections Edie McConaughey: Resident Core Curriculum Lecture: “Third Stage Labor” and “Complex Fetal Monitoring Cases” Core Clerkship Lecture “Intrapartum I and II”
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Core Clerkship Lecture “Electronic Fetal Monitoring: The Basics” Midwifery Faculty, Gestational Diabetic Clinic – with MFM Division Coordinator: PGY–1 Workshop Participating Workshop Faculty: PGY–1, Workshop for New Leaders Credentialed 1st Assist C-Sections Janet E. Singer: Resident Core Curriculum Lecture: “Surviving a Malpractice Trial” Core Clerkship Lecture: “Termination of Pregnancy” Core Clerkship Lecture “Intrapartum I and II” Participating Workshop Faculty: PGY–1, PGY–2, Workshop for New Leaders
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Linda A. Steinhardt: Resident Core Curriculum Lecture: “Second Stage Labor” Core Clerkship Lecture “Intrapartum I and II” Midwifery Faculty Coordinator, Gestational Diabetic Clinic – Tuesday PM with MFM Division Coordinator: Workshop for New Leaders Participating Workshop Faculty: PGY–1, Workshop for New Leaders Sylvia P. Ross: Core Clerkship Lecture: “Intrapartum I and II” Participating Workshop Faculty: PGY-1
HONORS/AWARDS Angelini: Guest Editor, Journal of Midwifery and Women’s Health, 2009 Hunter: Reappointed Peer Reviewer, Journal of Midwifery and Women’s Health, 2009 Singer: Appointed to Senior Clinical Teaching Associate, 2009 McConaughey: Nurse Faculty of the Year Award, 2010 Howard: Nurse Faculty of the Year Award, 2010
NATIONAL PRESENTATIONS Hunter L. Invited Speaker, “Women’s Health Care within an Inclusive Gender Model” “Reducing Inappropriate Inductions of Labor” American College of Nurse Midwives (ACNM) 55th Annual Meeting Washington, DC, June 2010. Ross S. Invited Speaker “Paving the Path: Midwives Teaching Nursing at the Baccalaureate Level” American College of Nurse Midwives (ACNM) 55th Annual Meeting, Washington, DC,
Nurse Midwifery
June 2010. Singer J. Invited Speaker “Caring for Families with Fetal and Neonatal Loss” and “Bleeding in Pregnancy” Massachusetts Nursing Association, Lawrence, MA , May 2010. Angelini D. Invited Speaker “Safety Parameters in OB Triage”, “Triage Case Studies”, “Delivery Complications” 27th Annual Obstetric Nursing Conference, Las Vegas, NV, April 2010. Howard, E. Invited Speaker “Preconceptual Counseling and “Management of Perinatal Depression and Substance Abuse and Depression” St. Thomas Hospital Risk Management Conference, Nashville, TN - 2009.
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LOCAL PRESENTATIONS Steinhardt L, McConaughey E, Hunter L. Invited Speakers “Developing a Workshop for New Leaders” Breakout Session, Warren Alpert Medical School of Brown University Clinical Faculty Workshop, Women and Infants’ Hospital, April 2010.
INTERNATIONAL PRESENTATIONS McConaughey E. Invited Speaker “Midwives as Educators of Medical Students and Residents: Results of a National Survey” 29th Annual International Nursing and Midwifery Research Conference, Royal College of Surgeons in Ireland, Dublin, Ireland, February 2010.
PUBLICATIONS McConaughey E, Howard E. Nurse Midwifery and Medical Education: Results of a National Survey. Journal of Midwifery and Women’s Health. 2009; 54: 268-274. Hunter L, Angelini D, Singer J. Levonorgestrel Emergency Contraception: An Update for Providers. Sexuality, Reproduction and Menopause. 2009; 7 (4): Available from http://www.srm-ejournal.com/article.asp?AID=8002. Angelini D. A National Survey of the Midwifery Directors Role in Academic Midwifery Practice Involved in Medical Education in the US. Journal of Midwifery and Women’s Health. 2009; 54 (4): 275-281. Angelini D, Stevens E, MacDonald A, Wiener S, Wieczorek B. Obstetric Triage: Models and Trends in Resident Education by Midwives. Journal of Midwifery and Women’s Health. 2009; 54 (4): 294-300.
Nurse Midwifery
OTHER Howard E, McConaughey E. “Midwives as Educators of Medical Students and Residents: Results of a National Survey.” 2009. ReachMD – Podcast Interview. The Channel for Medical Professionals. Available: http://reachmd.com. Howard E. “Midwives in Medicine”. Providence Business News. 2010.
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WOMEN & INFANTS HOSPITAL OF RHODE ISLAND OB/GYN GRAND ROUNDS SCHEDULE 2009-2010 July 2009 9
Peter Rosenblatt, MD Current and Future Treatments for Fecal Incontinence
16
Brenna Anderson, MD Hot Topics in Reproductive Infectious Disease
30
Stephan Krotz, MD Ovarian Aging and Fertility
August 2009 13
Nicole Korbly, MD Cesarean Scar Pregnancy
Jennifer Kang, MD Alcohol Use and Abuse in Pregnancy
27
Kyle Wohlrab, MD Complications in Urogynecologic Surgery
September 2009 3
Eve Espey, MD Strike While the Iron is Hot: Postpartum and Postabortal Contraception
10
Stephan Rubin, MD Hereditary Ovarian Cancer: Molecular Genetics and Clinical Implications
17
Donna LaFontaine, MD Some Observations on the Practice of Obstetrics/Gynecology in Kosovo
Grand Rounds
October 2009 1
Colleen Pelletier Surgical Consent
8
Stephen Bogdewic, PhD Organizational Culture: The Key to Success
15
Roxanne Gardner, MD Forming Your Hands for Practice: The Role of Simulation in Obstetrics and Gynecology
November 2009 5
Brenna Anderson, MD Update on Pandemic Influenza
Aine Clements, MD Updates in Ovarian Torsion
12
Nils Bergman, MD Perinatal Neuroscience and Skin-to-Skin Contact”
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December 2009 3
Julie Johnson, MD Thrombophilia and Pregnancy
January 2010 7
Raymond Powrie, MD Medical Causes of Maternal Mortality and What to do About Them
14
Agatha Critchfield, MD Pitocin Protocols
Katherine Melzer, MD Bariatric Surgery: Impact on Fertility, Contraception and Pregnancy
28
Brenna Anderson, James A. O’Brien, MD, Raymond Powrie, MD New Protocols for Postpartum Hemorrhage; New Protocols for Anticoagulation
February 2010 4
Peter Klatsky, MD Uterine Fibroids and Reproductive Outcomes: From Implantation to Delivery
March 2010 4
Katharine Wenstrom, MD The Fetal Origins of Adult Disease – Why Obstetrics is the Most Important Specialty
11
Gary Frishman, MD Hysteroscopy from the Office to the Operating Room
25
Beth Cronin, MD and Laura Richio, MD Robotics in Gynecologic Surgery: A Debate
April 2010 1 8
Gregory Dubel, MD Uterine Artery Embolization for Symptomatic Fibroids: Where Do We Stand in 2010? John Buster, MD Two Million Babies, 30 Years…What is Next in Reproductive Medicine?
May 2010 Lori Boardman, MD Contemporary Management of the Pap Test: Navigating Practice Guidelines
20
Charles Rardin, MD Update in Minimally-Invasive Urogynecology
27
Susan Cu-Uvin, MD Brown and the World: Engaging HIV-Infected Women
June 2010 3
Ashley Stuckey, MD Breast Cancer Screening
10
Jo Shapiro, MD Apology and Disclosure
Grand Rounds
6
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