department of obstetrics, gynecology, and reproductive sciences

Transcription

University of Pittsburgh School of Medicine
DEPARTMENT OF OBSTETRICS,
GYNECOLOGY, AND
REPRODUCTIVE SCIENCES
ANNUAL REPORT – ACADEMIC YEAR 2013
TABLE OF CONTENTS
DEPARTMENT OF OBSTETRICS,
GYNECOLOGY,
AND REPRODUCTIVE SCIENCES
UNIVERSITY OF PITTSBURGH
SCHOOL OF MEDICINE
ANNUAL REPORT
Academic Year 2013
July 1, 2012 – June 30, 2013
300 Halket Street
Pittsburgh, PA 15213
412.641.4212
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TABLE OF CONTENTS
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TABLE OF CONTENTS
YEAR IN REVIEW
MISSION STATEMENT ..................................................................................................................... 5
CHAIR’S ADDRESS ........................................................................................................................... 7
RECRUITMENTS ............................................................................................................................... 9
DEPARTURES ................................................................................................................................. 10
DEPARTMENT PROFESSIONAL MEMBERS ……………………………………………………………………………….11
DIVISION SUMMARIES OF RESEARCH, TEACHING AND CLINICAL PROGRAMS
DIVISION OF GYNECOLOGIC SPECIALTIES .................................................................................... 21
DIVISION OF GYNECOLOGIC ONCOLOGY ..................................................................................... 31
DIVISION OF MATERNAL FETAL MEDICINE .................................................................................. 39
DIVISION OF REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY ............................................ 42
DIVISION OF REPRODUCTIVE GENETICS....................................................................................... 53
DIVISION OF ULTRASOUND .......................................................................................................... 58
COMMUNITY PRACTICES SERVICE LINE ....................................................................................... 62
RESEARCH DIVISION REPORT
MAGEE-WOMENS RESEARCH INSTITUTE ..................................................................................... 75
RESEARCH GRANTS AND CONTRACTS.......................................................................................... 82
FUNDED RESEARCH ACTIVITIES .................................................................................................... 94
PUBLICATIONS (FY10-FY12) .......................................................................................................... 95
TEACHING ACTIVITIES
RESIDENCY TRAINING PROGRAM .............................................................................................. 149
2012 OBSTETRICS AND GYNECOLOGY RESIDENCY GRADUATES ............................................... 155
CLINICAL FELLOWSHIP ................................................................................................................ 156
CLINICAL REVENUE DATA AND TRENDING ................................................................................ 159
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TABLE OF CONTENTS
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MISSION STATEMENT
MISSION STATEMENT
The mission of the Department of Obstetrics, Gynecology and Reproductive Sciences is to
improve the lives of women through:

The provision of the highest quality of clinical care for women with complications in
pregnancy; gynecologic problems, gynecologic malignancies, infectious disease consultation,
infertility and endocrine disorders, genetics consultation and diagnostic ultrasound services.

The conduct of clinical and basic science research devoted entirely to investigation of the
full spectrum of diseases associated with the health of women and infants and the ability to
successfully translate these clinical and basic scientific findings into new clinical applications.

To provide the highest level of education and training to medical students, interns,
residents, postgraduate physicians, faculty, private practitioners, and other healthcare
providers that is an open-ended continuum with integration of all the subspecialties and to
create a highly satisfied professional environment for faculty, staff, and students.
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MISSION STATEMENT
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CHAIR’S ADDRESS
CHAIR’S ADDRESS
W. Allen Hogge, MD
Department Chair
This year’s annual report illustrates the hard work of over 200 outstanding faculty members. By
almost any metric this has been an exceptional year in clinical care, research, and education.
Expanding Clinical Care
Our clinical program continues to expand through a combination of strategic acquisitions, and
new models of care. A nine member practice of generalists in Pittsburgh was added to our
faculty, as well as additional generalists to our UPMC-Horizon group. We have developed a new
academic generalist group, known as University Ob/Gyn Associates to serve as the “clinical
laboratory” as we pilot new models of care in Ob/Gyn. Initiatives in both telemedicine and
“tele-ultrasound” have been developed, and rolled out to UPMC-Northwest, UPMC-Bedford,
UPMC-Hamot, and Washington Hospital. To provide both these telemedicine programs, and our
extensive outreach efforts, we added two ultrasound specialists, two reproductive
endocrinologists, two gynecologic oncologists, and two family planning specialists. Finally, we
are pleased to again be recognized by U.S. News & World Report, ranking 4th in gynecology.
Excelling in Research
Our investigators continue to have incredible success in obtaining grants, keeping us well
entrenched as the top funded Ob/Gyn department in the U.S., now with over 50 million dollars
of grants. Our faculty published over 200 peer-reviewed manuscripts during this past academic
year, and presented their work both nationally and internationally. This report gives you a sense
of the breadth and depth of our research enterprise.
Furthering Education
We are pleased that our efforts in education continue to gain both local and national
recognition. The University of Pittsburgh was ranked 4th among US medical schools for
education in Womens Health by U.S. News & World Report. Two of our faculty (Gary Sutkin and
Gabriella Gosman) were appointed to the University of Pittsburgh School of Medicine Academy
of Master Educators. Our residency program continues to attract outstanding candidates from
the top US medical schools, and our fellowship programs are filled by candidates from Yale
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CHAIR’S ADDRESS
University, University of California, San Francisco, University of Pennsylvania, and other top
residencies.
Despite our many successes, we are mindful that the healthcare landscape is changing. Our
clinical faculty actively are developing new approaches to provide efficient, cost-effective care
that will continue to keep our Department as a leader in Women’s Health.
W. Allen Hogge, MD
Milton Lawrence McCall Professor & Chair
Department of Obstetrics, Gynecology &
Reproductive Sciences
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DEPARTMENT PROFESSIONAL MEMBERS
RECRUITMENTS
PHYSICIAN
Tiffany Beck, MD
Michelle Moniz, MD
Nicole Donnellan,MD
Kiran Perkins, MD
Kitilia Smith, MD
Bethany Calaway Hahn, MD
Sonyoung (Sunny) Seo, MD
Michelle Tate, MD
Devereus Nathaniel Saller, MD
Ari Heffron, MD
Maryanne Hugo, MD
Robert Thomas, MD
Renata Hoca, MD
Elizabeth Hazel, MD
Charles Kremser, MD
Anne Shaheen, MD
Katharine Goetz, MD
Donald Carson, MD
Steele Filipek, MD
Isabelle Wilkins, MD
Kenneth Spisso, MD
HIRED
7/1/2012
7/1/2012
7/1/2012
7/23/2012
8/1/2012
8/1/2012
9/1/2012
9/1/2012
10/1/2012
11/1/2012
2/1/2013
2/1/2013
2/1/2013
2/1/2013
2/1/2013
2/1/2013
2/1/2013
2/1/2013
2/1/2013
2/1/2013
6/1/2013
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DEPARTURES
PHYSICIAN
Ganya Alvarado, MD
Emily Lebovitz, MD
Kristina Bishop, MD
Amy Yester, MD
Pamela Kridgen, MD
Judy Balk, MD
Kristen Zorn, MD
Beth Prairie, MD
Marcia Klein-Patel, MD
Kelly Devoogd, MD
Thomas Krivak, MD
Corrine Brown-Robinson
Shareece Davis, MD
Deidre Lum, MD
Christina Pisani, MD
DEPARTED
12/28/2012
12/28/2012
12/28/2012
12/28/2012
12/28/2012
1/03/2013
3/28/2013
3/31/2013
4/3/2013
5/3/2013
5/31/2013
6/30/2013
6/30/2013
6/30/2013
6/30/2013
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Department Professional Members
PROFESSORS
Stanley (Steve) Caritis, MD
Mitchell Creinin, MD
Daniel Edelstone, MD
Robert Edwards, MD
Lyndon Hill, MD
Sharon Hillier, PhD
W. Allen Hogge, MD
Joseph Kelley, MD
Kathleen McIntyre-Seltman, MD
Tony Plant, PhD
James Roberts, MD
Yoel Sadovsky, MD
Joseph Sanfilippo, MD
Gerald Schatten, PhD
Anthony Zeleznik, PhD
ASSOCIATE PROFESSORS
Judith Balk, MD,MPH
Yaacov Barak, PhD
Charlene Dezzutti, PhD
Gabriella Gosman, MD
Richard Guido, MD
Carl Hubel, PhD
Marijane Krohn, PhD
Pamela Moalli, MD,PhD
Francesmary Modugno, PhD
Kyle Orwig, PhD
David Peters, PhD
Aleksander Rajkovic, MD,PhD
Hyagriv Simhan, MD
William Walker, PhD
Margaret Watt-Morse, MD
Harold Wiesenfeld, MD,CM
Halina Zyczynski, MD
ASSISTANT PROFESSORS
Sharon Achilles, MD, PhD
Thomas Krivak, MD
Aletha Akers, MD,MPH
Dennis Krivinko, MD
Richard Beigi, MD,MSc
Daniel Lattazni, MD
Michael Bonidie, MD
Faina Linkov, PhD
Katherine Bunge, MD
Jerry Lowder, MD
Timothy Canavan, MD
Suketu Mansuria, MD
Janet Catov, PhD
Alexander Olawaiye, MD
Eeva Liisa Kristiina
Judy Chang, MD,MPH
Parviainen-Yang, MD
Beatrice Chen, MD
Robert Powers, MD
Tianjiao Chu, PhD
Beth Ann Prairie, MD
Jennifer Condon, PhD
Roberta Renzelli-Cain, DO
Noedahn Copley-Woods, MD
Scott Richard, MD
Bonnie Coyne, MD
Edward Sandy, MD
Miriam Cremer, MD
Christina Scifres, MD
Nicole Donnellan, MD
Paul Speer, MD
Stephen Emery, MD
David Streitman, MD
Robert Gedekoh, MD
Paniti Sukumvanich, MD
Chiara Ghetti, MD
Gary Sutkin, MD
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Stephen Hasely, MD
Katherine Himes, MD
Heather Hohmann, MD
Jie Hu, MD,PhD
Xin Huang, PhD
Arundhathi Jeyabalan, MD
Robert Kaminski, MD
Marcia Klein-Patel, MD, PhD
Morris Turner, MD
Glenn Updike, MD
Anda Vlad, PhD
Judith Yanowitz, PhD
Alexander Yatsenko, MD,PhD
Svetlana Yatsenko, MD
Kristin Zorn, MD
RESEARCH ASSISTANT PROFESSORS
Takuya Mishima, MD, PhD
Malini Sathanorri, MD
Jeyasuria Pancharatnam, PhD
Yi Sheng, PhD
Suresh Ramaswamy, PhD
RESEARCH ASSOCIATE PROFESSORS
Bernard Moncla, PhD
Calvin Simerly, PhD
Abhiram Sahu, PhD
RESEARCH INSTRUCTORS
Carlos Castro, MD,DMD
Su-Yeon Kim, PhD
MinJae Lee, PhD
Jean-Francois Mouillet, PhD
Tali Shalom-Barak, PhD
Xiao Hua Shi, MD
Wenjun Zong, MD
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RESIDENTS
FOURTH-YEAR RESIDENTS
Michelle M. Boisen, MD - University of Wisconsin School of Medicine and Public Health
Serena Chan, MD - Oregon Health Sciences University School of Medicine
Amanda Ecker, MD - Oregon Health Sciences University School of Medicine
Karyn Hansen, MD - University of South Carolina School of Medicine
Paula Duncan, MD –Northeastern Ohio University College of Medicine
Leslie Moroz, MD - Jefferson Medical College of Thomas Jefferson University
Sheila Ramgopal, MD - University of Pittsburgh School of Medicine
Jennifer Salati, MD - University of Pittsburgh School of Medicine
Meredith Snook, MD - University of Pittsburgh School of Medicine
THIRD-YEAR RESIDENTS:
Megan Bradley, MD - University of Pittsburgh School of Medicine
Katherine Cook, MD – Medical College of Wisconsin
Rosemary Froehlich, MD – SUNY Upstate Medical University
Hilary Hinshaw, MD - Indiana University School of Medicine
Jennifer Lanzer, MD - Medical College of Georgia School of Medicine
Michelle Rowland, MD, MPH, PhD - University of Illinois College of Medicine
Eirwen Scott, MD – Wayne State University School of Medicine
Erin Seifert, MD – University of Washington School of Medicine
Raj Swati Shree, MD – Saint Louis University School of Medicine
SECOND-YEAR RESIDENTS:
Katarzyna Bochenska, MD – University of Illinois College of Medicine
Tracy L. Clary, MD - Case Western Reserve University School of Medicine
Nicole M. Falls, MD - University of Alabama School of Medicine
Lee M. Hammons, MD - University of Washington School of Medicine
Michelle Y. Louie, MD - George Washington University School of Medicine Health Sciences
Christine Poisson, MD - Wayne State University School of Medicine
Megan M. Quimper, MD – University of Pittsburgh School of Medicine
Jonathan D. Ratzersdorfer, MD – University of Medicine and Dentistry of New Jersey
Frances M. Stafford, MD – University of Alabama School of Medicine
M. Crystal Yu, MD – University of Illinois College of Medicine
FIRST-YEAR RESIDENTS:
Anna B. Binstock, MD - University of Maryland School of Medicine
Anne K.C. Davis, MD, MS – University of California at San Francisco School of Medicine
Lauren E. Giugale, MD – University of Virginia School of Medicine
Jessica K. Lee, MD - University of Pittsburgh School of Medicine
Lauren M. Lewis, MD - George Washington University School of Medicine Health Sciences
Jennifer T. Paul, MD - Rush Medical College
Malcolm S. Ross, MD – University of North Carolina School of Medicine at Chapel Hill
Stephanie S. Rothenberg, MD - University of Washington School of Medicine
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Margaret R. Schramm, MD - Georgetown University School of Medicine
Roxanna M. Twedt, MD – University of Nevada School of Medicine
FELLOWS
Female Pelvic Medicine and Reconstructive Surgery Fellows (Urogynecology):
Laura Skoczylas
Medical School Jefferson Medical College, Philadelphia, PA
Residency University of California Irvine Medical Center, Orange, CA
HONORS
 American Urogynecologic Society (AUGS) Foundation – June Allyson Award 2010
 Magee-Womens Research Institute – Clinical Trainee Research Award 2010
Sallie Oliphant
Medical School University of North Carolina School of Medicine
Residency University of Pittsburgh, Magee-Womens Hospital
HONORS
 MWRI-Clinical Trainee Research Award 2009-2010
Rebecca Shaffer, MD
Medical School: University of Washington School of Medicine
Residency: University of Vermont Department of OB/Gyn
Kelly Kantartzis, MD
Medical School: University of Pittsburgh School of Medicine
Residency: University of Pittsburgh Magee-Womens Hospital
Minimally Invasive Surgery Fellows:
Nicole Donnellan
Deirdre Lum , MD
Medical School: University of California, San Francisco School of Medicine
Residency: University of California
Gynecologic Oncology Fellows:
Jamie Lesnock, MD
Med School: Vanderbilt University
Residency: Magee-Womens Hospital of UPMC
Bunja Rungruang, MD
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Med School: University of Alabama
Ashlee Smith, DO
Med School: Philadelphia College of Osteopathic Medicine
Residency: Geisinger Medical Center – Dept of OB/Gyn
Jeff Lin, MD
Medical School: Northwestern University Feinberg School of Medicine
Residency: New York Presbyterian Hospital, Weill Cornell Medical Center
Robin Laskey, MD
Medical School: Virginia Commonwealth University School of Medicine
Residency: Duke University Medical Center
Family Planning Fellows:
Jennefer Russo, MD
Medical School: George Washington University School of Medicine
Residency: Harbor UCLA Medical Center
Torrance, California
Rachel Rapkin, MD
Medical School: University of Miami Miller School of Medicine
Medical Genetics Fellows:
Nancy Hendrix, MD
Medical School: Medical College of Georgia
Residency: Medical College of Georgia, Dept. OB/GYN
Augusta, Georgia
Lina Ghaloul-Gonzalez, MD
Medical School: University of Salamanca, Salamanca Spain
Residency in Internal Medicine: State University of New York at Buffalo
Buffalo, New York
Shibani Kanungo, MD
Medical School: I.M. Sechenov Moscow Medical Academy
Residency: State University of New York
Pankaj Thakur, MD
Medical School: Manipal college of Medical Sciences
Residency: Creighton University Medical Center
Reproductive Infectious Diseases Fellow:
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Catherine Chappell, MD
Medical School: University of Texas Southwestern Medical School
Residency: University of Texas Southwestern – Parkland Memorial Hospital
Maternal Fetal Medicine Fellows:
Justine Chang, MD
Medical School: University of Washington, Seattle
Residency: Brown University
Courtney Cuppett, MD
Medical School: West Virginia University
Residency: West Virginia University
Shareece Davis, MD
Medical School: Loma Linda University Medical Center
Residency: University of California
David Kanter, MD
Medical School: University of Chicago Hospitals
Residency: Rush University
Christina Pisani, MD
Medical School: New Jersey Medical School
Residency: University of Medicine and Dentistry, New Jersey
Karen Florio, DO
Medical School: New York College of Osteopathic Medicine
Residency: University of Missouri, Columbia Graduate School
Devon Raemaker, MD
Medical School: Sanford School of Medicine
Sara Sakamoto, MD
Reproductive Endocrinology and Infertility Fellows:
Shweta Nayak, MD
Medical School: Northeastern Ohio University Coll of medicine
Residency: Northwestern University, McGaw Medical Center
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Melanie Ochalski, MD
Medical School: University of Medicine and Dentistry of New Jersey – Robert Wood Johnson
Medical School
Shruti Malik, MD
Medical School: Northwestern Ohio University College of Medicine
Residency: Summa Health Systems Akron City Hospital
Global Health Fellowship:
Debrah Landis Lewis, MD
DEPARTING FELLOWS JUNE 30, 2012:
Female Pelvic Medicine and Reconstructive Surgery Fellows:
Laura Skoczylas, MD
Current position: Faculty
Kaiser Permanente West LA Medical Center
Los Angeles, CA
Minimally Invasive Surgery Fellows:
Current Position: Faculty
University of Pittsburgh, Magee Womens Hospital, Ob/Gyn/RS
Pittsburgh, PA
Gynecologic Oncology Fellows:
Jamie Lesnock, MD
Current Position: Gynecologic Oncologist
Midatlantic Gynecologic Oncology of Mon General
Morgantown, WV
Bunja Rungruang, MD
Current Position: Gynecologic Oncologist
Georgia Health Sciences University, Department of Ob/Gyn
Augusta, GA
Family Planning Fellows:
Jennefer Russo, MD
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Current Position: Medical Director
Planned Parenthood of Orange and San Bernardino Counties
Orange, CA
Medical Genetics Fellows:
Lina Gonzalez, MD
Current Position: Fellow
Medical Biochemical Genetics Fellowship, Children’s Hospital of UPMC
Reproductive Infectious Diseases Fellow:
None
Maternal Fetal Medicine Fellows:
Justine Chang, MD
Current Position: MFM Faculty
University of Washington, Department of Ob/Gyn
Seattle, WA
Courtney Cuppett, MD
West Virginia University, Department of Ob/Gyn
Morgantown, WV
David Kanter, MD
UMass Memorial Medical Center
Worchester, MA
Reproductive Endocrinology and Infertility:
Melanie Ochalski, MD
Current Position: Reproductive Endocrinologist
Fertility Center LLC
York, PA
Global Health Fellowship:
Debrah Landis Lewis, MD
Current Position: Faculty
Ketchikan General Hospital
Ketchikan, AK
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CLINICAL FACULTY
Ira Abramowitz, MD
Janice Agnes, MD
Judith Albert, MD
Carey Andrew-Jaja, MD
Meredith Annon, CNM
David Badway, MD
Sharon Baer, DO
Linda Barnhart, DO
Rifaat Bassaly, MD
Tiffany Beck, MD
Kristina Bishop, MD
Sandra Blaser, CNM
Michael Bummer, MD
Draion Burch, DO
Jamie Cannon, MD
Stacey Jill Carlitz, DO
Kathleen Carroll, MD
Donald Carson, MD
Richard Chalfant, MD
Edwin Cheek, MD
Carol Chesin, MD
Wayne Christopherson, MD
Robert Collins, MD
Lisa Cone, CNM
Sandra Cooper, CNM
Stephen Corey, MD
James Crozier, MD
Emily Deferrari, CNM
David Deitrick, DO
Tabitha Delo, MD
Bradley Dennis, MD
Preeta Divekar, MD
April Dunmyre, DO
Michael England, MD
Dennis English, MD
Eric Fackler, MD
Steele Filipek, MD
John Fisch, MD
Rocco Florio, DO
Hubert Foka, MD
Rocco Fulciniti, MD
James Garver, MD
Katharine Goetz, MD
Suzanne Griffith, MD
Elizabeth Hazel, MD
Ari Heffron, MD
Leonard Hess, MD
Renata Hoca, MD
Maryanne Hugo, MD
Dian Ichikawa, MD
Amy Imro, MD
Renue Joshi, MD
Sondra Kapnadak, MD
Sunita Katari, MD
David Earl Kauffman, MD
Andrew Kellerman, MD
Marta Kolthoff, MD
Charles Kremser, MD
Carol Krupski, MD
Susan Lareau, MD
Teh-Min Lee, MD
Jamie Lesnock, MD
Leona Logan, CNM
Christine Burke London, CNM
Michael Lupinetti, MD
Carol Manspeaker, CNM
Jerry George Martin, MD
Bart Matson, DO
Shannon McCabe, CNM
Mark McCormick, MD
William McGrail, Jr., MD
Kimberly Melen, MD
John Myers, DO
Christine Nagy, MD
Satish Nayak, MD
Stephanie Nicholas, MD
Hossein Noorbakhsh, MD
Joanne Oleck, MD
Mary Olson, MD
Murray Osofsky, MD
Sonyoung Seo Patel, MD
Mary Peterson, MD
Dean Pollack, MD
George Poutous, MD
Christine Rause, MSN, CRNP
Nicole Rawson, CNM
Ira M Rock, MD
Zenaida Rosado, MD
George Rosenberg, MD
Deanna Rutman, MD
Sandra Rygg, MD
Samuel Seiavitch, MD
Elizabeth Seiders, MD
Evan Shikora, MD
Suzanne Shores, MD
Robert Simmonds, MD
Kitilia Smith, MD
Deborah Sommer, MD
Claver Soriano, MD
Kenneth Spisso, MD
Michele Straka, MD
Leeann Swanson, MD
Michele Tate, MD
Harati Tatineni, MD
Robert Thomas, MD
Anthony Wakim, MD
Nicole Waltrip, MD
Laura Wanderly, CNM
Michaela Ward, CNM
Deborah Whiteside, MD
Shirley Woo, MD
Michele Wright, DO
Richard Zigrossi, MD
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DIVISION OF GYNECOLOGIC SPECIALTIES
Harold C. Wiesenfeld,
MD, CM
Division Director
OVERVIEW
The Gynecologic Specialties Division continued growth and development to maintain our
primary mission related to the care of women with gynecologic disorders. We had our most
productive clinical year in the history of the division, seeing more patients than ever before.
During the academic year, the Division members provided:
 Clinical care as both primary providers of obstetrics and gynecology services and
referral specialists within our areas of sub-specialty.
 Research including 27 peer-reviewed publications, 25 abstracts at national meetings,
and funding from government, foundation, and industry sources totaling nearly $4
million.
 Teaching of medical students, residents and fellows.
RESEARCH PROGRAM
Our Division continues to be extremely productive in research with funding from government,
foundation, and industry sources totaling nearly $4 million. Division members authored 27
peer-reviewed publications and presented 25 oral, poster or video abstracts at national
meetings.
Dr. Judith Chang is the principal investigator of and NNIF-funded RO1 examining patientprovider communication on alcohol and drug use during pregnancy. She recently completed her
K08 work on patient provider communication on partner violence.
Dr. Chen is a site investigator for the NIAID Microbicide Trials Network and a principal
investigator or co-investigator on several clinical trials on new contraceptive technologies and
abortion methods, funded by government, industry, and foundations.
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Dr. Miriam Cremer’s research focus is on cervical cancer screening in El Salvador. She is
investigating low cost HPV testing and cryotherapy in women with cervical dysplasia to reduce
the incidence of cervical cancer in El Salvadorian women.
Dr. Guido is involved in clinical research regarding cervical cancer screening, HPV, and
colposcopy. Dr. Guido is also the PI on the BRTE 2 study, an intramural NCI-funded study to
begin looking for a new early marker for endometrial cancer.
Dr. Marcia Klein-Patel is a K-12 award recipient through the Magee-Womens Research Institute.
In collaboration with our colleagues in the Division or Urogynecology and Pelvic Reconstructive
Medicine, she is examining the foreign body reaction in pelvic floor reconstruction,
characterizing the immune response to synthetic meshes used in pelvic organ prolapse repair.
Dr. Prairie was awarded a BIRCWH K12 and is studying mood symptoms and sexual function in
peri-menopausal and early post-menopausal women. She received the New Investigator Award
from the American Society of Bone and Mineral Research and her poster presentation was
awarded first prize at the North American Menopause Society.
Dr. Wiesenfeld is a Project and Core Leader on a NIH_ funded U-19 grant entitled “The UPMC
Sexually Transmitted Infections Cooperative Research Center” evaluating the pathogenesis and
treatment of acute PID. He has recently completed, as principal investigator, a NIH-funded R01
grant on subclinical PID comparing the impact on fertility of two antibiotic regimens for
subclinical PID. Dr. Wiesenfeld is also the principal investigator and co-investigator on several
clinical trials on reproductive infections including a study funded by the Centers for Disease
Control and Prevention evaluating the role of Chlamydia trachomatis in infertility among U.S.
women.
Dr. Sharon Achilles joined our division in July 2011. She is principal investigator of an NIH R01
grant quantifying immune cells in women using contraception. She has also received funding
from the Bill and Melinda Gates foundation for her work defining HIV-target cell response in
women initiating contraception in high HIV-incidence areas.
Study Sections/Advisory Committee Memberships
1.
Dr. Guido
 Chair, Institutional Review Board, University of Pittsburgh
 Chair, ACOG Committee Adolescent Health Committee
 ASCCP Membership Committee (co-chair)
 ASCCP Resident Education and Practice Subcommittee Member
 ASCCP Executive Board Member
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2.
3.
4.
5.
Dr. Lee
 AAGL CME Advisory Committee
 AAGL Abstract Committee
 Program Committee for the 2011 Annual Meeting of Society of Gynecologic Surgeons
Dr. Mansuria
 Chair, American Association of Gynecologic Laparoscopists Video Presentation
Committee
Dr. McIntyre-Seltman
 Board of Directors and Assistant Treasurer, International Federation of Societies of
Colposcopy
 ABOG Senior Examiner
Dr. Wiesenfeld
 Co-Chair, Infectious Diseases Group, National Action Plan for the Prevention,
Detection, and Management of Infertility, Centers for Disease Control and
Prevention
 Consultant, 2010 STD Treatment Guidelines, Centers for Disease Control and
Prevention
 Member, American College of Obstetricians and Gynecologists Committee on
Practice Bulletins- Gynecology
Editorships
1.
Dr. Guido
 Editorial Board, Journal of Lower Genital Tract Diseases
2.
Dr. Lee
 Editorial Board: Journal of American Association of Gynecologic Laparoscopists
3.
 Editor: Journal of Lower Genital Tract Diseases
4.
Dr. Wiesenfeld
 Editorial Board: Sexually Transmitted Diseases
 Associate Editor: Infectious Diseases in Obstetrics and Gynecology
TEACHING ACTIVITIES
Our Division members maintain a position in academic medicine because of their continued
commitment to teaching. All surgically active division members rotate as the Resident Service
Attending. We are the primary providers of gynecologic teaching in resident continuity clinics.
Dr. Updike, in his role as the Director of the Outpatient Clinic, continues to update clinical
programming and expand services. During this past academic year, our division ran specialty
clinics in colposcopy (4 sessions weekly), family planning (2 sessions weekly), urgent care (9
sessions weekly), vulvar disease (1 session weekly) and perioperative management (2 sessions
weekly).
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Our division teaching conferences include:
 Gynecology Conference—Monday morning 0715-0815: a two-segment conference with
alternating weeks:
- A 30 minute evidenced-base 3rd year resident presentation with assigned topics
based on a weekly curriculum followed by a thirty minute clinical presentation of
patients and treatment decisions by the Senior resident on the University
Gynecology service.
- A 45 minute lectures by a Family Planning fellow, a Minimally Invasive Surgery
fellow or a Reproductive Infectious Disease fellow followed by a fifteen minute
clinical presentation of patients and treatment decisions by the Senior resident on
the University Gynecology service.
 Colposcopy Conference—Monday morning 0815-0900: weekly review of colposcopic
pattern recognition and cytology-histology-colposcopy correlation.
 Teaching rounds: the attending on service provides teaching rounds every Monday,
Wednesday and Friday morning at 0630. Monday am is focused on cases or issues from
the weekend or left over from the prior week. Wednesday and Friday am should focus
on the topic of the week.
Residency Rotations
PGY
University Gynecology
4th, 3rd, 2nd, 1st
Family Planning
4th
Special Clinics (colposcopy and pre-op clinics)*
4th
Minimally Invasive Surgery
4th
Gynecology Consultation
2nd
Urgent Care Gynecology
1st
Ambulatory Gynecology
4th, 1st
* also attends private office hours in Midlife Health Center for teaching related to the care of
menopausal patients
Medical Student Education
Medical Student education is also a priority. All division members participate as faculty
preceptors for Problem Based Learning sessions during the 3rd year Clerkship in Obstetrics and
Gynecology. Many of the faculty participate in courses throughout the main medical school
curricula and special programs such as the Clinical Scholars Training Program.
Medical Student Education leadership
2nd year Reproductive Biology Course: Richard Guido, MD, course co-director
4th year Obstetrics and Gynecology electives: Richard Guido, MD, director
 available electives within our division: research, Independent private practice,
University Gynecology, Minimally Invasive Surgery, Family Planning
24
4th year Reproductive Infectious Disease ILS Course: Harold Wiesenfeld, MD, CM, course
director
th
4 year Pelvic Anatomy ILS Course: Suketu Mansuria, MD, course director
4th year Women’s Health Elective: Kathleen McIntyre-Seltman, MD, clerkship co-director
4th year Family Planning Elective: Beatrice Chen, MD, director
4th year Minimally Invasive Gynecologic Surgery Elective: Ted Lee, MD, director
4th year Ambulatory Gynecology Elective: Harold Wiesenfeld, MD, director
Dr. McIntyre-Seltman is an elected member of the University Of Pittsburgh Academy Of Master
Educators, and an Advisory Dean in the Student Affairs Department of the Medical School,
overseeing advancement of medical students throughout their curriculum.
Professional Affiliations
1.
2.
3.
4.
Dr. Achilles
 European Society of Contraception and Reproductive Health
 American Society for Reproductive Immunology
 Society of Family Planning
 National Abortion Federation
 American Sexually Transmitted Diseases Association
 Association of Reproductive Health Professionals
 International Union Against Sexually Transmitted Infections
 American College of Obstetricians and Gynecologists
 American Medical Association
 Women in Medicine
 National Peace Corps Association 1994-Current
Dr. Chang
 Fellow, ACOG
 Member, American Professors of Obstetrics & Gynecology
 Member, Academy Health
 Member, American Public Health Association
 Member, American Academy on Communication in Health Care
 Member, Society of Gynecologic Investigation
 Member, American Balint Association
Dr. Chen
 Fellow, ACOG
 Member, Society of Family Planning
 Member, Association of Reproductive Health Professionals
 Member, National Abortion Federation
 Member, Physicians for Reproductive Choice and Health
Dr. Copley-Woods
 Fellow, ACOG
 Member, Practice GreenHealth
25
 Member, American Society for Colposcopy and Cervical Pathology
 Member, North American Menopause Society
 Member, American Association of Gynecologic Laparoscopists
5.
Dr. Cremer
 Member, Society for Family Planning
 Member, Association of Reproductive Health Professionals
6.
Dr. Guido
 Fellow, ACOG
 Member, Association of American Gynecologic Laparoscopists
 Fellow, American Society for Colposcopy & Cervical Pathology
 Member, Association of Professors of Obstetrics & Gynecology
 Member, American Society of Pediatric and Adolescent Gynecology
7.
Dr. Lee
 Fellow, ACOG
 Member, American Urogynecologic Society
8.
Dr. Mansuria
 Fellow, ACOG
 Member, Society of Laparoendoscopic Surgeons
 Member, American Society for Reproductive Medicine
9.
 Fellow, ACOG
 Member, Alpha-Omega-Alpha (AOA) Medical Honor Society
 American Society for Colposcopy and Cervical Pathology
 Association of Professors of Gynecology and Obstetrics
10.
Dr. Peterson
 Fellow, ACOG
11.
Dr. Prairie
 Fellow, ACOG
 Member, American College of Preventive Medicine
12.
Dr. Updike
 Fellow, ACOG
 Member, American Society for Colposcopy and Cervical Pathology
 Member, National Vulvodynia Association
13.
Dr. Wiesenfeld
 Fellow, ACOG
 Member, Infectious Diseases Society for Obstetrics and Gynecology (IDSOG)
 Member, American STD Association
 Member, Infectious Diseases Society of America
 Member, Royal College of Physicians and Surgeons of Canada
FELLOWSHIPS
26
The Division offers fellowships in Family Planning, Minimally Invasive Surgery (in conjunction
with the Division of Reproductive Endocrinology and Infertility) and Reproductive Infectious
Diseases. Our faculty also contributes to the teaching of fellows and junior faculty in other
University departments, including the Women’s Health fellows from the Department of
Medicine. Additionally, Dr. Chang serves as a core faculty member of the Center for Research in
Health Care where she has co-developed and co-teaches a fellow/junior faculty level course on
Qualitative Research Methods.
The Family Planning Fellowship is a two-year program designed to include training in family
planning clinical care, experience in gynecologic surgery and related family planning procedures,
participation in the design and performance of clinical trials and international field work. During
the two years, the fellow is encouraged to complete course work at the Graduate School of
Public Health at the University of Pittsburgh to satisfy the requirements of a Master’s Degree in
Public Health. Course work can involve a multidisciplinary approach or a departmental
curriculum including biostatistics, epidemiology and health care administration. The program is
intended to foster the pursuit of an academic career by overall emphasis on and preparation for
clinical research and teaching. Fellows are specifically trained in contraceptive counseling,
contraceptive implant insertion and removal, IUD insertion and removal, and the fitting of
diaphragms. Additionally, fellows gain expertise in treating complications of hormonal
contraception. Although these procedures may have been learned during residency, a
concentrated experience will enable the fellow to be proficient with unusual or complicated
cases. Fellows receive specialized training and become very experienced in performing first
trimester procedures including manual vacuum aspiration and medical abortions. Fellows will
have similar experience with second trimester abortions by dilation and evacuation (D&E). The
fellows are an active participant in ongoing trials as well as be expected to design and conduct
his/her own research trial. Fellows also gain experience in grant writing, budgeting, contracts,
and other administrative aspects of clinical research. Fellows are also expected to spend time
working in the developing world on advances in contraception and access to care. This
international experience is designed to further the fellow's understanding of issues related to
the impact of high fertility rates and poor access to reproductive health services for
contraception and pregnancy care. Three-year programs are available for individuals with an
additional interest in Reproductive Genetics or Reproductive Infectious Disease.
The Minimally Invasive Surgery Fellowship is a two-year intense academic training program
which focuses on minimally invasive surgery. The program is designed to provide extensive
training in endoscopic surgery from the gynecologic and general surgical perspectives. During
the two years, the fellow is encouraged to complete course work at the Graduate School of
Public Health at the University of Pittsburgh to satisfy the requirements of a Master’s Degree in
Public Health. Course work can involve a multidisciplinary approach or a departmental
curriculum including biostatistics, epidemiology and health care administration. A research
project is an integral part of the program with the expectation that it is submitted at a national
27
level and published in a peer-reviewed journal. Other activities include active participation in
resident and student teaching programs and private patient sessions.
The Reproductive Infectious Diseases fellowship is a two-year program designed to train
obstetrician gynecologists in the clinical care of women with complex infections of the
reproductive tract. The fellows receive intensive training on both inpatient units and outpatient
settings, mastering the management of common and less-common reproductive tract infections
including complex vaginitis, pelvic inflammatory disease, pelvic infections following surgery,
hospital-acquired infections, and obstetrical infections. Trainees gain experience in the
management of HIV-positive women in collaboration with members if the Division of Infectious
Diseases in the Department of Medicine. The fellowship includes training on antimicrobial
management and pharmacology. A large proportion of the fellowship is devoted to training in
clinical and translational research, with the goal of designing and completing a research project
during the fellowship. Fellows are required to complete postgraduate coursework in research
design and methods, statistics, and many fellows successfully complete a Master’s degree in
Public Health or Clinical Research.
CLINICAL PROGRAMS
The main clinical location is located at Magee-Womens Hospital with an office on the zero level
that focuses on general and specialty gynecologic services and an office on the 5th floor that
focuses on midlife health. We have a satellite office where Drs. Hohmann, Prairie and CopleyWoods sees patients in the North Hills. Dr. Chang primarily sees patients in the Montefiore
General Internal Medicine offices. Dr. DeVoogd also sees patients at the UPMC Mt. Oliver
complex. We also integrate residents and fellows into our offices for subspecialty education.
Dr. Guido runs a collaborative program with Department of Radiology for Fibroid care. In
addition to gynecologic care, Drs. Wiesenfeld and Updike also have a busy obstetric practice.
We continue to have an open access schedule into our office to maximize the availability of our
specialists for new and return problem visits. A new patient with a problem can see a physician
in our practice within 3 business days. The total number of office sessions by our division
members remained stable at nearly 1,500 sessions. Our division members performed over
2,000 surgical procedures in the operating room. In addition, we performed over 400 surgical
procedures in our office.
We continue to work on finding a balance between providing continuing routine care for
women who desire to use our group as their primary gynecologists and being available as
specialists to the Pittsburgh and surrounding areas.
Outreach/contracted care:
28
Veteran’s Administration Hospital Women’s Health Services: Dr. McIntyre-Seltman
Planned Parenthood of Western Pennsylvania: Dr. Chen—Medical and Laboratory Director
Allegheny County Health Department: Dr. Wiesenfeld—Director, STD Program
Magee-Womens Hospital Outpatient Clinical Services: Glenn Updike, MD, MMM—Director
Magee-Womens Hospital Women with Disabilities Clinic: Glenn Updike, MD
Magee-Womens Hospital Mt. Oliver Clinic: Kelly DeVoogd, DO
General Internal Medicine Comprehensive Women’s Health Clinic (Montefiore): Judy Chang,
MD, MPH
Specialties:
Judy Chang, MD, MPH
Beatrice Chen, MD, MPH
Noe Copley-Woods, MD
Miriam Cremer, MD, PhD
Richard Guido, MD
Heather Hohmann, MD, MPH
Ted Lee, MD
Suketu Mansuria, MD
Kathy McIntyre-Seltman, MD
MaryBeth Peterson, MD
Beth Prairie, MD
Glenn Updike, MD
Harold Wiesenfeld, MD, CM
Family Planning, Reproductive Infectious Diseases
Domestic Violence, Health Services Research
Family Planning
Gynecologic Ecology
Family Planning, Global Health
Minimally Invasive Surgery, Cervical Dysplasia, Pediatric
Gynecology
Family Planning
Minimally Invasive Surgery, Pelvic Pain management
Cervical Dysplasia, Vulvar Disease
Menopause and Midlife Health
Menopause and Midlife Health, Preventive Medicine
Vulvar Disease
Reproductive Infectious Diseases, Vulvar Disease
29
Faculty
Harold Wiesenfeld, MD, CM Director
Judy Chang, MD, MPH
Miriam Cremer, MD, MPH
Robert Gedekoh, MD
Richard Guido, MD
Heather Hohmann, MD, MPH
Ted Lee, MD
Suketu Mansuria, MD
Kathy McIntyre-Seltman, MD
MaryBeth Peterson, MD
Beth Prairie, MD
Glenn Updike, MD
Harold Wiesenfeld, MD, CM
Kim Barcasky, CRNP
Sara Berty, CRNP, CNM
Chris Rause, CRNP
Helen Fries, BSN, MS, CMPE (Division Manager)
Fellows
Family Planning
Rachel Becker
Christy Boraas
Deidre Lum, MD
Cara Robinson King, DO
Dina Chamsy
Infectious Disease
Catherine Chappell, MD
WEBSITE: http://obgyn.medicine.pitt.edu/gynecology
30
DIVISION OF GYNECOLOGIC ONCOLOGY
OVERVIEW
Joseph Kelley, MD
Division Director
For the academic year of 2012-2013, the Division of Gynecologic Oncology had a productive
performance with continued evolution of its clinical, research and teaching agendas. The
division’s missions are multi-faceted and include comprehensive and compassionate care of
women afflicted with breast and gynecologic malignancies, the enhancement of care through
the use of basic science, translational and clinical research, education of future healthcare
providers, and advocacy for awareness. To that end, there has been a marked increase in both
our clinical activity, growth of our research agenda and expansion of our educational
commitment.
Our core clinical group consists of 8 full-time gynecologic oncologists, one part-time
gynecologist, four PhDs and a support staff of approximately 35 individuals. We are based at
Magee Womens Hospital but provide outreach services throughout South Western
Pennsylvania. Offices and surgical services are offered at Mercy Hospital, North Hills Passavant
Hospital, St. Clair Hospital, Hamot, Northwest Hospital, Horizon Hospital and Sewickley Hospital.
Outreach offices are located at UPMC Cancer Centers as well as additional offices in Cranberry
Township, Erie and Latrobe. Future sites of development include offices in the South Hills region
of Pittsburgh and Altoona. Approximately 2854 new patients (17 % increase) were seen with
10,341 return patient visits and 1500 visits to the chemotherapy unit. Our charges were
approximately 15.8 million dollars. UPMC accounts for roughly 76 % of the gynecologic
oncology market share in Allegheny County and 51 % of the market share in the surrounding 29
counties. This is an increase in growth compared to the prior academic year.
The research agenda is multi-dimensional and includes areas of interest that range from clinical
breast cancer studies, molecular profiling of the tumor, microenvironment in gynecologic cancer
prevention, investigator initiated targeted therapy and immunotherapy clinical trials, and
locoregional strategies for the treatment and prevention of peritoneal cancers. Funding has
been robust, topping out at roughly $3.0 million in the past academic year including new
extramural funding this year from the National Cancer Institute and Ovarian Cancer Research
31
Fund. Clinical trials are active at our site from both collaborative group trials to include the
Gynecologic Oncology Group (GOG), a number of pharmaceutical industry supported initiatives
as well as three investigator initiated trials. Division members are active on committees within
the GOG and have raised our national presence.
Successful recruitment of two senior research scientists has led to the development of a joint
program between the Magee Womens Research Institute and the University of Pittsburgh
Cancer Institute. The Women’s Cancer Research Center under the guidance of Dr. Adrian Lee
and Steffi Oesterreich has broadened the research efforts in both gynecologic and breast
malignancies. In the past year, there have been over 27 presentations at national and regional
meetings in the past academic year and there have been over 45 publications in in peer
reviewed journals, including high impact journals such as Nature and the Journal of
Experimental Medicine.
As always, the division remains focused on its academic mission to include education of the next
generation of health care providers. To that end the division, has been active in both didactic
and bedside teaching of medical student, residents and fellows. Our fellowship program is
robust and approved by American Board of Obstetrics and Gynecology.
RESEARCH PROGRAM
Our research program was extremely productive with a wide variety of clinical, translational and
basic science studies. Total funding for the division consists of $3,007,650. The research
activities of the division are multifaceted and well-funded. The division produced 45 publications
and a total of 27 presentations at regional and national meetings.
Dr. Edwards serves as the Director of Gynecologic Oncology Research. His interest includes
vaccine therapies for cervical and ovarian cancer, combining biologic and immunologic therapies
with traditional therapies in the treatment of women’s cancer and intraperitoneal therapy.
The division faculty has expanded collaborations with our colleagues at the Magee-Womens
Research Institute (MWRI) and the University of Pittsburgh Cancer Institute (UPCI). Currently, 4
PhD faculty and 3 clinicians maintain active laboratories at MWRI. With the recruitment of Drs.
Lee and Oesterreich to oversee breast and gynecologic cancer research the entire fourth floor of
MWRI now houses the Women’s Cancer Research Center and is supported by both UPCI and
MWRI. This center has Dr. Lee as the director and Dr. Edwards as co-director. The Center’s
purpose is to create a shared resource for women’s cancer research across the University of
Pittsburgh and UPMC. Dr. Oesterreich was specifically charged with developing mentoring
programs for post-doctoral and clinical fellows as well as lectureships and graduate student
programs.
The division is a principle member of The Gynecologic Oncology Group, a national non-profit
organization dedicated to clinical and translational research in the field of gynecologic cancers.
32
The mission of the Gynecologic Oncology Group is to enhance the treatment of gynecologic
cancer through research encompassing surgery, chemotherapeutic intervention, radiation
therapy, pathology, immunology, outcomes research, and gynecologic nursing. The organization
receives support from the National Cancer Institute. The Gynecologic Oncology Group has a long
history of establishing treatment standards for ovarian and endometrial cancer. Currently, over
3,300 patients are registered per year on Gynecologic Oncology Group research trials. To date
the Gynecologic Oncology Group has completed over 300 clinical trials and contributed over 500
manuscripts to peer-reviewed medical literature. In its 35-year history, the organization has
been at the forefront in developing new strategies in the management of gynecologic cancers.
The GOG will merge into the new clinical trial organization to be known as the NRG which will
include the National Surgical Adjuvant Breast and Bowel Project, the GOG and the Radiation
Therapy Oncology Group in the early part of 2014.
In the past academic year, all the trials based at Magee Womens Hospital have merged with the
Clinical and Translational Science Institute under the umbrella of the University of Pittsburgh
Cancer Institute and are now offered throughout the UPMC system. This has led to enhanced
opportunities for our colleagues and their patients in the surrounding communities to receive
cutting edge therapy through enrollment in clinical trials. In the past year 20% of the patients
enrolled on clinical trials were enrolled from our community outreach sites.
The Division of Gynecologic Oncology is one of fifty parent members of GOG. Five division
members serve on committees within the GOG. In the academic year 2012-2013 the division
had 20 clinical trials available for patient accrual. The disease sites include ovarian, uterine,
cervical carcinomas and gestational trophoblastic disease.
An active tissue procurement program exists on site at Magee Womens Hospital. This
has been matched with an active informatics base and serves as a resource for
investigators with the University of Pittsburgh Medical Center. Dr. Edwards serves as
the Director of Transformational Medicine for UPMC and has promoted, together with
Dr. Lee, the focus of the new Enterprise Electronic Data Warehouse (EDW) on cancer
genomics for breast and gynecologic cancers.
Xin Huang, PhD joined the division faculty in 2009. Dr. Huang focuses his research on epigenetic
regulation through micro-RNA on hypoxia in solid tumors. His current focus is on ovarian cancer
biology in primary disease and recurrence. He has several projects funded to evaluate the role of
microRNA as potential cancer biomarkers.
Dr. Joseph Kelley has varied research interests to include novel therapies for ovarian cancer,
fertility options and preservation for patients undergoing therapy for both gynecologic and
breast malignancies, application of sentinel node technology to gynecologic cancers and
enhancement of the role of supportive care, palliative care and hospice care in the gynecologic
oncology patient population. He and his colleagues recently completed an investigator initiated
trial on the pharmacogenomics of taxotere in patients with ovarian cancer.
33
Dr. Thomas Krivak initiated a basic science program and has a research technician working in his
lab. In 2007, Dr. Krivak received the Gynecologic Oncology Group New Investigators Award. He
evaluates the role of single nucleotide polymorphisms in the development of ovarian cancer as
well as in metabolic changes associated with treatment of ovarian cancer. Dr. Krivak works
extensively with the GOG on collaborative translational projects and has mentored several
fellows. Many of these projects have been platform presentations at national meetings which
significantly raise the profile of the Division research program.
The division has added two faculty interested in cancer epidemiology in response to the new
interest by the NIH in “team science” initiatives. These individuals will work to connect our
tissue bank and clinical resources to outcome data available on populations across the UPMC
system.
Faina Linkov Ph.D is an assistant professor and has interests related to the role obesity plays in
cancer development and other diseases. She is currently funded by a career development
award from the American Cancer Society. Her studies involve evaluating the role that weight
loss, including bariatric surgery-induced weight loss, have on cancer prevention. Dr. Linkov
actively collaborates with investigators within the University of Pittsburgh as well as across the
country.
A recent addition to our faculty, Francesmary Modugno, PhD, MPH is an associate professor
who works on large cohort studies of ovarian cancer populations. She recently completed a
large cohort study of over 500 patients prospectively enrolled across western Pennsylvania and
eastern Ohio referred to as the HOPE study (Hormones in Ovarian Cancer Progression). Dr.
Modugno also has interest in breast and endometrial cancer.
Dr. Alex Olawaiye has multiple clinical research interests and is currently investigating novel
therapies for advanced endometrial cancer. Other areas of interest include the psychosocial
impact of disease and the roles of educators in the development of our resident physicians.
Dr. Sukumvanich has a special interest in developing electronic databases for clinical research in
gynecologic oncology. He has developed a mentoring program for residents and fellows to track
their case list and provide a research database for clinical projects from the same activity.
Anda Vlad, PhD joined the Division Faculty in 2007. Her laboratory on the fourth floor of MageeWomens Research Institute is shared and adjacent to that of Dr. Robert Edwards. Dr. Vlad’s
research explores the murine models of endometriosis and parallel cohorts of human specimens
from our tissue bank to clarify the role endometriosis may play in ovarian cancer. Dr. Vlad has
mouse models which recapitulate the human disease in a mouse model system developing
endometriosis and frank invasive ovarian cancer. Dr. Vlad also has several recent papers define
the expression of MUC-I tumor antigens in ovarian cancer and investigates with her Murine
preclinical model as well as with human specimens the role of MUC-1 in ovarian cancer
development. Dr. Vlad was one of 8 applicants selected for the prestigious DOD mentored
34
career development award in the DOD ovarian cancer academy. Dr. Edwards serves as her
mentor on this award. In addition, Dr. Vlad with the assistance of Dr. Yoel Sadovsky and Dr.
Edwards has developed the core facility for flow cytometry at MWRI funded through
philanthropy. In the past year, Dr. Vlad was awarded her first R01 to study the role transgenic
modification on the tumor microenvironment in cancer development.
Dr. Kristin Zorn has developed a focused research interest in the surveillance and early detection
of ovarian cancer in women with high risk features. She has further developed and promoted
the Ovarian Cancer High Risk Center at the Hillman Cancer Center. Funding has been obtained
from both the Scaife and Shapira Family Trusts. Dr. Zorn was granted a Women’s Reproductive
Health Research Award (WRHR Award) and completed the 2 year program in the spring of 2012.
Some Examples of current investigator-initiated research studies:
Faculty:
Robert P. Edwards, MD/ Anda Vlad, PhD/ Xin Huang, PhD/ Bill Bigbee, PhD
Title:
A Multidisciplinary Program Evaluating Endometriosis-associated Ovarian
Cancer
The novel program is funded through a UPMC initiative to promote paradigm changing medical
research. It is a two-year funding initiative which seeks to identify new mechanisms and
biomarkers of ovarian carcinogenesis through the precursor lesions in endometriosis. Multiple
sophisticated platforms, including molecular profiling, serum bank screening, and proteomics,
are being utilized on archived paraffin specimens housed in the Magee-Womens Hospital Tissue
Bank. This grant funds several postdoctoral positions who work exclusively on this project under
the direction of the 4 principal investigators. Dr. Bigbee is the director of the UPCI proteomics
core and works in collaboration with the division members. This human tissue project runs in
parallel with Dr. Vlad’s mouse model work and will lead to novel new approaches for screening
and treatment of ovarian cancer.
Faculty:
Kristin Zorn, MD/Robert P. Edwards, MD
Title:
Phase I Dose –Escalation Parallel Study of Docetaxel/Intraperitoneal Oxaliplatin
and Intraperitoneal Docetaxel/Intravenous Oxaliplatin in Platinum-Sensitive and
Platinum Resistant Recurrent Ovarian, Primary Peritoneal and Fallopian Tube
Cancer
This is a $430,000.00 study supported by Sanofi Aventis. It is to evaluate the pharmacokinetics
and peritoneal biology influence by the infusion of these two chemotherapy agents in addition
to look at the impact of the intraperitoneal infusion on the primary cancer biology for ovarian
and ovarian like cancers.
35
Late Breaking news within our research agenda is the anticipated grant of a Specialized
Programs of Research Excellence (SPORE) award for ovarian cancer. This SPORE will
promote collaborative, interdisciplinary translational cancer research and the grant
involves both basic and clinical/applied scientists and support projects that will result in
new and diverse approaches to the prevention, early detection, diagnosis and treatment of
this disease.
TEACHING PROGRAM
The division members are dedicated to the education of health care providers. Teaching for the
Division includes the following group of individuals:
1. Gynecologic Oncology fellows
2. Residents in Obstetrics, Gynecology and Reproductive Sciences
3. University of Pittsburgh and Chatham College Physician Assistant Nurse Practitioner
Programs
4. Medical students of the University of Pittsburgh
5. Visiting Surgical Oncology Fellows
6. Visiting Medical Oncology Fellows
7. Community outreach
Teaching activities occur in didactic lecture setting, in small problem based learning groups, in
our outpatient offices, the inpatient units, and in the operating room. Education centers around
the diagnosis and treatment of gynecologic and breast malignancies. The faculty hopes to
impart an understanding of the pathophysiology of the disease process as well as therapeutic
interventions. The faculty members emphasize preoperative and postoperative management as
well as surgical technique. Special attention is taken to expose the trainees to the nuances of
patient-physician communication with an emphasis on discussing the delivery of difficult and
unexpected news.
All faculty participate in Problem Based Learning Sessions for third year medical students in their
clinical clerkships. Dr. Joseph Kelley recently received an Excellence in Teaching Award from the
Association of Professors of Gynecology and Obstetrics for his efforts in this program.
A 4th year Medical Student elective in gynecologic oncology has been received enthusiastically
by the University of Pittsburgh Students. On average, 8 students per year participate in this
month long rotation.
Formal educational events include:
36
Tumor Board
The Division of Gynecologic Oncology sponsors a weekly multi-disciplinary Tumor Board that
focuses on patient management issues and current trends in gynecologic oncology. Individuals
within the subspecialties of gynecologic oncology, medical oncology, radiation oncology,
radiology, pathology, patient care services and social work attend it. Clinical dilemmas,
controversial and unusual patient cases are selected by the attending staff and discussed by the
participants. Radiographic and pathologic findings are correlated with the clinical findings. The
attendees discuss rationale for an approach to the clinical problem.
This Conference allows discussion of different approaches to the problems encountered in
gynecologic oncology. The opportunity to recruit patients within research protocols occurs
during this meeting.
In the past year, the conference has been revamped to include PowerPoint presentations of all
cases, the use of “mini-debates” and the encouragement to discuss patients in a prospective
fashion. A didactic lecture series has been started to compliment this important conference.
Didactic Lecture Series in Gynecologic Oncology
A recent addition has been a weekly core lecture series covering topics in the field.
Presentations by the attending staff and colleagues in other subspecialties enhance the
educational experience of the attendees. The second and third year residents are assigned a
topic to discuss and an attending faculty mentors them.
Journal Club
Every six weeks a divisional Journal Club is held to discuss timely and controversial topics in the
field of Gynecologic Oncology. The attending staff and/or the house staff choose topics. An
attending physician and senior resident moderate the session.
An additional Journal Club has been developed and chaired by Dr.Scott Richard and focuses on
fellow education. The conference is held weekly and focused topics in gynecologic cancer are
addressed including intensive review of current and past Gynecologic Oncology Group trials.
Ob/Gyn and Gyn/Onc Patient Safety Conference
An Ob/Gyn Patient Safety Conference has been established and occurs every 6 weeks during the
Thursday morning Core Lecture Series. The primary goal of the conference is the identification
and management of complications of obstetrical and gynecological care. The house staff is
encouraged to identify patient events of concern. A list is generated of events and presented at
the conference. Four to five cases are discussed in detail with subsequent suggestions from the
house staff and attendings.
37
A separate Gynecologic Oncology Patient Safety conference was recently established and occurs
every 6 weeks on Friday morning. All available residents, fellows and attending participate as
adverse and challenging outcomes are discussed.
Fellowship
The Division has an American Board of Obstetrics and Gynecology (ABOG) approved fellowship
in gynecologic oncology. The program is 3 years in duration. The program admits two
candidates per year with a yearly total complement of 6 individuals. Fellows have research
training to include participation in the core Clinical Research Training Program. In addition, the
fellow may elect to pursue a Master of Science in Clinical Research. Fellows will gain exposure to
NIH-funded trials through the Gynecologic Oncology Group (GOG), Radiation Therapy Oncology
Group (RTOC), and many other ongoing clinical and basic research projects. Clinical training is
enhanced by active multidisciplinary collaboration with the Departments of Obstetrics and
Gynecology, General Surgery, Radiology, Critical Care Medicine, Internal Medicine, Radiation
Oncology and Surgical Oncology The fellowship underwent a site review in May 2010 and our
fellowship was renewed for another 5 years.
The division has been asked by the Society of Gynecologic Oncologists to spearhead the
development of fellowship in Breast Oncology to complement the existing program. Fellows in
the gynecologic oncology fellowship will have the option of spending an additional year in this
program to enhance their clinical skills. The program is currently in the development phase and
funding is being sought to support this initiative.
CLINICAL PROGRAM
The division is now composed of 8 full time gynecologic oncologists. This rapid expansion has
allowed us to improve access to care for women of Southwestern Pennsylvania for treatment of
gynecologic and breast malignancies. The faculty is energized and dedicated to its mission.

The Women’s Cancer program at Magee-Womens Hospital/UPMC has continued to
expand with the division of Gynecologic Oncology providing a vital role in this process.
The number of patients diagnosed and cared for at our institution has grown in the past
five years.
The total number of patient’s seen in the Gynecologic Oncology outpatient office for the last 7
years are:
FY 13
FY12
2,854
New Patients & Consults
2,796
10,341
Return Patients
10,841
38
The total estimated charges and payments for the Division as follows:
FY12
FY13
Charges
$19,979,808
$15,780,489
Payments
$4,900,216
$ 4,228,817
Established clinical initiatives include:
 Ovarian Cancer Assessment and Surveillance Program
 Ovarian Cancer Center of Excellence
 Tissue Procurement Program
 Gynecologic Oncology Fellowship
 Outreach programs to Erie, Horizon Hospital, Irwin, Latrobe, Mercy Hospital, Moon
Township, North Hills Passavant Hospital, Sewickley Valley Hospital and Uniontown.
Additional initiatives that will be completed in the next academic year or in the developmental
phase include:
 Recruitment of ADDITIONAL Clinical and Research Staff
- Two Gynecologic Oncologist with 80 % clinical commitment
- Gynecologic Oncologist with 70 % research commitment
 Development of a Clinical Fellowship in Breast Oncology
FACULTY LISTING
Joseph L. Kelley, MD
Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
Director, Division of Gynecologic Oncology
Wayne C. Christopherson, MD
Clinical Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
John T. Comerci, M.D.
Clinical Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
Robert P. Edwards, M.D.
Professor and Executive Vice-Chair, Department ofGynecology and Reproductive Sciences,
Director, Gynecologic Oncology Research, Secondary appointment in Department of
Immunology
39
Thomas C. Krivak, MD
Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
Director of Gynecologic Oncology Fellowship
Wayne C. Christopherson, MD
Clinical Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
Paniti Sukumvanich, MD
Assistant Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
Director of the Gynecologic Oncology Fellowship
Dr. Alexander Olaiwaye, MD
Kristin K. Zorn, MD
Research:
Xin Huang Ph.D
Faina Linkov PHD
Francemary Modugno PhD
Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences
Anda M. Vlad, PhD
Secondary appointment Department of Immunology
Secondary Appointments:
Adrian Lee Ph.D.
Professor, Department of Pharmacology & Chemical Biology
40
Steffi Oesterreich Ph.D.
Professor, Department of Pharmacology & Chemical Biology
Current Trainees
Jeff Lin, MD
Robin Laskey, MD
Carolyn Casey Lefkowits, MD
Sarah Taylor, MD
Michelle Boisen, MD
Karyn Hansen, MD
Jessica Berger, MD
Past Trainees (and where they have appts)
Ashlee Smith, DO – 2010-2013
Geisinger Health System, Danville, PA
Jamie Lesnock, MD – 2009-2012
Mid-Atlantic Gynecologic Oncology of Mon General Hospital
Morgantown, WV
Bunja Rungruang, MD – 2009 - 2012
Georgia Regents University, August, GA
Ebony Hoskins, MD – 2008 - 2011
Mercy Health, St. Mary’s Campus, Grand Rapids, MI
Jennifer Rubatt, MD – 2008 - 2011
Cancer Centers of North Carolina, Raleigh, NC
William McBee, MD – 2007 - 2010
Mid-Atlantic Gynecologic Oncology of Mon General Hospital
Morgantown, WV
Rebecca Byler-Dann, MD – 2006 - 2009
OSF St Francis Medical Center, Peoria, IL
Scott Richard, MD 2005 - 2008
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Hahnemann University, Philadelphia, PA
Alfred Guirgus, MD 2004 - 2007
Rush University, Chicago, IL
WEBSITE: http://obgyn.medicine.pitt.edu/oncology/
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DIVISION OF MATERNAL FETAL MEDICINE
OVERVIEW
Hyagriv Simhan, MD, MSCR
Division Director
The Maternal-Fetal Medicine (MFM) Division has continued its tradition of high-level scholarly
and academic contributions and productivity. MFM faculty have authored more than 4 first- and
senior-authored publications in the past academic year. Our publications include important,
high-impact papers on perinatal issues as diverse as twin-to-twin transfusion syndrome, preeclampsia pathogenesis, placental fat transport, nutrition in pregnancy, development of
standards of fetal growth, genital tract immunologic predisposition to preterm birth,
pharmacology of progesterone, identification of risk for adverse pregnancy outcomes among
women in their first pregnancy, and stress contributors to preterm birth. The Division continues
to be successful in securing federal research funding, with NIH and CDC funded projects on preeclampsia, preterm birth prevention, nutrition in pregnancy, and pharmacology in pregnancy
representing the key funded areas in our portfolio.
The Division is particularly excited about our junior faculty K awardees, representing the future
of clinical and translational perinatal research. The Division has 3 K-funded faculty (Larkin,
Himes, Facco), each of whom have already contributed significantly to the research environment
here in Pittsburgh, as well as nationally, through their high-level presentations and publications.
From a clinical perspective, the division continues its long tradition of inpatient high-risk
antepartum care and outpatient consultative services. We have expanded our offereing of MFM
services through an innovative Telemedicine program, bringing outpatient MFM consultation to
three outreach communites that would otherwise not have access to this degree of subspecialty
service.
Moving into the future, in addition to continuing our robust portfolio of research in preterm
birth, preeclampsia, pharmacology, and placental function, the Division anticipates growth and
development in the areas of fetal therapy and the developmental origins of adult diseases, and
pregnancy as a window into women’s health over the life course. These two areas are
scientifically cutting edge and hold great promise for improving public health over the next 10+
years.
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Divisional publications for July 1, 2012 – June 30, 2013
1. Bailit JL, Grobman WA, Rice MM, Spong CY, Wapner RJ, Varner MW, Thorp JM,
Leveno KJ, Caritis SN, Shubert PJ, Tita AT, Saade G, Sorokin Y, Rouse DJ,
Blackwell SC, Tolosa JE, Peter Van Dorsten J. Risk-Adjusted Models for Adverse
Obstetric Outcomes and Variation in Risk Adjusted Outcomes Across Hospitals. Am
J Obstet Gynecol. 2013 Jul 24. doi:pii: S0002-9378(13)00751-5.
10.1016/j.ajog.2013.07.019. [Epub ahead of print] PMID: 23891630.
2. Caritis SN, Hebert MF. A pharmacologic approach to the use of glyburide in
pregnancy. Obstet Gynecol. 2013 Jun;121(6):1309-12. doi:
10.1097/AOG.0b013e31829007f0. PMID: 23812467.
3. Figueroa D, Landon MB, Mele L, Spong CY, Ramin SM, Casey B, Wapner RJ,
Varner MW, Thorp JM Jr, Sciscione A, Catalano P, Harper M, Saade G, Caritis SN,
Sorokin Y, Peaceman AM, Tolosa JE; for the Eunice Kennedy Shriver National
Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine
Units (MFMU) Network. Relationship Between 1-Hour Glucose Challenge Test
Results and Perinatal Outcomes. Obstet Gynecol. 2013 Jun;121(6):1241-1247.
PMID: 23812458.
4. Grobman WA, Gilbert SA, Iams JD, Spong CY, Saade G, Mercer BM, Tita AT,
Rouse DJ, Sorokin Y, Leveno KJ, Tolosa JE, Thorp JM, Caritis SN, Peter Van
Dorsten J; for the Eunice Kennedy Shriver National Institute of Child Health and
Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network.
Activity Restriction Among Women With a Short Cervix. Obstet Gynecol. 2013
Jun;121(6):1181-1186. PMID: 23812450.
5. Zephyrin LC, Hong KN, Wapner RJ, Peaceman AM, Sorokin Y, Dudley DJ, Iams JD,
Harper M, Caritis SN, Mercer BM, Thorp JM, Ramin SM, Rouse DJ, Sibai B; Eunice
Kennedy Shriver National Institute of Child Health and Human Development
Maternal-Fetal Medicine Units (MFMU) Network. Gestational age-specific risks vs
benefits of multicourse antenatal corticosteroids for preterm labor. Am J Obstet
Gynecol. 2013 Jun 13. doi:pii: S0002-9378(13)00617-0. 10.1016/j.ajog.2013.06.009.
[Epub ahead of print] PMID: 23770471.
6. Grobman WA, Lai Y, Rouse DJ, Spong CY, Varner MW, Mercer BM, Leveno KJ,
Iams JD, Wapner RJ, Sorokin Y, Thorp JM Jr, Ramin SM, Malone FD, O'Sullivan MJ,
Hankins GD, Caritis SN; Eunice Kennedy Shriver National Institute of Child Health
and Human Development Maternal-Fetal Medicine Units Network. The association of
cerebral palsy and death with small-for-gestational-age birthweight in preterm
neonates by individualized and population-based percentiles. Am J Obstet Gynecol.
2013 Jun 13. doi:pii: S0002-9378(13)00615-7. 10.1016/j.ajog.2013.06.007. [Epub
ahead of print] PMID: 23770470.
7. Thorp JM Jr, Rice MM, Harper M, Klebanoff M, Sorokin Y, Varner MW, Wapner RJ,
Caritis SN, Iams JD, Peaceman AM, Mercer BM, Sciscione A, Rouse DJ, Ramin
SM, Anderson GB; Eunice Kennedy Shriver National Institute of Child Health and
Human Development Maternal–Fetal Medicine Units Network. Advanced lipoprotein
measures and recurrent preterm birth. Am J Obstet Gynecol. 2013 Jun 13. doi:pii:
S0002-9378(13)00613-3. 10.1016/j.ajog.2013.06.005. [Epub ahead of print] PMID:
23770464.
8. Caritis SN, Zhao Y, Venkataramanan R, Bettinger J. Reply. Am J Obstet
Gynecol.2013 Apr 30. doi:pii: S0002-9378(13)00472-9. 10.1016/j.ajog.2013.04.038.
44
9. Harper M, Li L, Zhao Y, Klebanoff MA, Thorp JM Jr, Sorokin Y, Varner MW, Wapner
RJ, Caritis SN, Iams JD, Carpenter MW, Peaceman AM, Mercer BM, Sciscione A,
Rouse DJ, Ramin SM, Anderson GD; Eunice Kennedy Shriver National Institute of
Child Health and Human Development Maternal-Fetal Medicine Units Network.
Change in mononuclear leukocyte responsiveness in midpregnancy and subsequent
preterm birth. Obstet Gynecol. 2013 Apr;121(4):805-11. doi:
10.1097/AOG.0b013e3182878a80. PMID: 23635681.
10. Chiossi G, Lai Y, Landon MB, Spong CY, Rouse DJ, Varner MW, Caritis SN,
Sorokin Y, Oʼsullivan MJ, Sibai BM, Thorp JM, Ramin SM, Mercer BM; Eunice
(NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Timing of delivery and
adverse outcomes in term singleton repeat cesarean deliveries. Obstet Gynecol.
2013 Mar;121(3):561-9. doi: 10.1097/AOG.0b013e3182822193. PMID: 23635619.
11. Caritis SN, Zhao Y, Bettinger J, Venkataramanan R. Qualitative and quantitative
measures of various compounded formulations of 17-alpha hydroxyprogesterone
caproate. Am J Obstet Gynecol. 2013 Jun;208(6):470.e1-5. doi:
10.1016/j.ajog.2013.02.028. Epub 2013 Feb 20. PMID: 23453884; PMCID:
PMC3672260.
12. Caritis SN. Reply. Am J Obstet Gynecol. 2013 Apr;208(4):337-8. doi:
10.1016/j.ajog.2012.12.033. Epub 2013 Jan 4. PMID: 23295980.
13. Ma KK, Mele L, Landon MB, Spong CY, Ramin SM, Casey B, Wapner RJ, Varner
MW, Rouse DJ, Thorp JM Jr, Sciscione A, Catalano P, Harper M, Saade G, Caritis
SN, Sorokin Y, Peaceman AM; for the Eunice Kennedy Shriver National Institute of
Child Health and Human Development Maternal-Fetal Medicine Units Network. The
Obstetric and Neonatal Implications of a Low Value on the 50-g Glucose Screening
Test. Am J Perinatol. 2012 Dec 27. [Epub ahead of print] PMID: 23271384.
14. Pillai VC, Strom SC, Caritis SN, Venkataramanan R. A sensitive and specific CYP
cocktail assay for the simultaneous assessment of human cytochrome P450
activities in primary cultures of human hepatocytes using LC-MS/MS. J Pharm
Biomed Anal. 2013 Feb 23;74:126-32. doi: 10.1016/j.jpba.2012.10.016. Epub 2012
Oct 22. PMID: 23245243; PMCID: PMC3654816.
15. Gyamfi-Bannerman C, Gilbert S, Landon MB, Spong CY, Rouse DJ, Varner MW,
Caritis SN, Meis PJ, Wapner RJ, Sorokin Y, Carpenter M, Peaceman AM, O'Sullivan
MJ, Sibai BM, Thorp JM, Ramin SM, Mercer BM; Eunice Kennedy Shriver National
Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine
Units (MFMU) Network. Risk of uterine rupture and placenta accreta with prior
uterine surgery outside of the lower segment. Obstet Gynecol. 2012
Dec;120(6):1332-7. doi: http://10.1097/AOG.0b013e318273695b. PMID: 23168757;
PMCID: PMC3545277.
16. Costantine MM, Mele L, Landon MB, Spong CY, Ramin SM, Casey B, Wapner RJ,
Varner MW, Rouse DJ, Thorp JM Jr, Sciscione A, Catalano P, Caritis SN, Sorokin
Y, Peaceman AM, Tolosa JE, Anderson GD; Eunice Kennedy Shriver National
Institute of Child Health and Human Development Maternal-Fetal Medicine Units
Network, Bethesda, Maryland. Customized versus Population Approach for
Evaluation of Fetal Overgrowth. Am J Perinatol. 2013 Aug;30(7):565-72. doi:
10.1055/s-0032-1329188. Epub 2012 Nov 12. PMID: 23147078; PMCID:
PMC3657303.
17. Sharma S, Ellis EC, Gramignoli R, Dorko K, Tahan V, Hansel M, Mattison DR,
Caritis SN, Hines RN, Venkataramanan R, Strom SC. Hepatobiliary disposition of
17-OHPC and taurocholate in fetal human hepatocytes: a comparison with adult
45
human hepatocytes. Drug Metab Dispos. 2013 Feb;41(2):296-304. doi:
10.1124/dmd.112.044891. Epub 2012 Nov 5. PMID: 23129211; PMCID:
PMC3558857.
18. Berggren EK, Mele L, Landon MB, Spong CY, Ramin SM, Casey B, Wapner RJ,
Varner MW, Rouse DJ, Sciscione A, Catalano P, Harper M, Saade G, Caritis SN,
Sorokin Y, Peaceman AM, Tolosa JE; Eunice Kennedy Shriver National Institute of
Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units
(MFMU) Network. Perinatal outcomes in Hispanic and non-Hispanic white women
with mild gestational diabetes. Obstet Gynecol. 2012 Nov;120(5):1099-104. doi:
http://10.1097/AOG.0b013e31827049a5. PMID: 23090528; PMCID: PMC3531801.
19. Thorp JM, Camargo CA, McGee PL, Harper M, Klebanoff MA, Sorokin Y, Varner
MW, Wapner RJ, Caritis SN, Iams JD, Carpenter MW, Peaceman AM, Mercer BM,
Sciscione A, Rouse DJ, Ramin SM, Anderson GB; Eunice Kennedy Shriver National
Institute of Child Health and Human Development Maternal-Fetal Medicine Units
Network. Vitamin D status and recurrent preterm birth: a nested case-control study in
high-risk women. BJOG. 2012 Dec;119(13):1617-23. doi: 10.1111/j.14710528.2012.03495.x. Epub 2012 Oct 19. PMID: 23078336; PMCID: PMC3546544.
20. Grobman WA, Thom EA, Spong CY, Iams JD, Saade GR, Mercer BM, Tita AT,
Rouse DJ, Sorokin Y, Wapner RJ, Leveno KJ, Blackwell S, Esplin MS, Tolosa JE,
Thorp JM Jr, Caritis SN, Van Dorsten JP; Eunice Kennedy Shriver National Institute
of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU)
Network. 17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas
with cervical length less than 30 mm. Am J Obstet Gynecol. 2012
Nov;207(5):390.e1-8. doi: 10.1016/j.ajog.2012.09.013. Epub 2012 Sep 17. PMID:
23010094; PMCID: PMC3484249.
21. Caritis SN, Sharma S, Venkataramanan R, Hankins GD, Miodovnik M, Hebert MF,
Umans JG, Benedetti T, Mattison D, Zajicek A, Fischer D, Jackson A; Eunice
Obstetrical-Fetal Pharmacology Research Units Network. Pharmacology and
placental transport of 17-hydroxyprogesterone caproate in singleton gestation. Am J
Obstet Gynecol. 2012 Nov;207(5):398.e1-8. doi: 10.1016/j.ajog.2012.08.015. Epub
2012 Aug 16. PMID: 22967833; PMCID: PMC3586341.
22. Caritis SN, Simhan HN, Zhao Y, Rouse DJ, Peaceman AM, Sciscione A, Spong CY,
Varner MW, Malone FD, Iams JD, Mercer BM, Thorp JM Jr, Sorokin Y, Carpenter M,
Lo J, Ramin SM, Harper M; Eunice Kennedy Shriver National Institute of Child
Health and Human Development Maternal-Fetal Medicine Units Network.
Relationship between 17-hydroxyprogesterone caproate concentrations and
gestational age at delivery in twin gestation. Am J Obstet Gynecol. 2012
Nov;207(5):396.e1-8. doi: 10.1016/j.ajog.2012.08.001. Epub 2012 Aug 6. PMID:
22959763; PMCID: PMC3484214.
23. Andres RL, Zhao Y, Klebanoff MA, Hauth JC, Caritis SN, Carey JC, Wapner RJ,
Iams JD, Leveno KJ, Miodovnik M, Sibai B, Van Dorsten JP, Dombrowski MP,
O'Sullivan MJ, Langer O; Eunice Kennedy Shriver National Institute of Child Health
and Human Development Maternal-Fetal Medicine Units Network. The impact of
tobacco use on preterm premature rupture of the membranes. Am J Perinatol. 2013
Mar;30(3):185-90. doi: 10.1055/s-0032-1322517. Epub 2012 Aug 28. PMID:
22930157.
24. Costantine MM, Clark EA, Lai Y, Rouse DJ, Spong CY, Mercer BM, Sorokin Y, Thorp
JM Jr, Ramin SM, Malone FD, Carpenter M, Miodovnik M, O'Sullivan MJ, Peaceman
46
AM, Caritis SN. Association of polymorphisms in neuroprotection and oxidative
stress genes and neurodevelopmental outcomes after preterm birth. Obstet Gynecol.
2012 Sep;120(3):542-50. PMID: 22914463.
25. Costantine MM, Lai Y, Bloom SL, Spong CY, Varner MW, Rouse DJ, Ramin SM,
Caritis SN, Peaceman AM, Sorokin Y, Sciscione A, Mercer BM, Thorp JM, Malone
FD, Harper M, Iams JD; Eunice Kennedy Shriver National Institute of Child Health
and Human Development Maternal-Fetal Medicine Units Network. Population versus
customized fetal growth norms and adverse outcomes in an intrapartum cohort. Am J
Perinatol. 2013 Apr;30(4):335-41. doi: 10.1055/s-0032-1324708. Epub 2012 Aug 14.
PMID: 22893556; PMCID: PMC3622136.
26. Haas DM, Quinney SK, Clay JM, Renbarger JL, Hebert MF, Clark S, Umans JG,
Caritis SN; Obstetric-Fetal Pharmacology Research Units Network. Nifedipine
pharmacokinetics are influenced by CYP3A5 genotype when used as a preterm
labor tocolytic. Am J Perinatol. 2013 Apr;30(4):275-81. doi: 10.1055/s-00321323590. Epub 2012 Aug 8. PMID: 22875663.
27. Caritis SN, Simhan H. Cervical pessary use and preterm birth: how little we know.
Lancet. 2012 May 12;379(9828):1769-70. doi: 10.1016/S0140-6736(12)60116-0.
Epub 2012 Apr 3. PMID: 22475492.
28. Gilbert SA, Grobman WA, Landon MB, Spong CY, Rouse DJ, Leveno KJ, Varner
MW, Caritis SN, Meis PJ, Sorokin Y, Carpenter M, O'Sullivan MJ, Sibai BM, Thorp
JM, Ramin SM, Mercer BM; Eunice Kennedy Shriver National Institute of Child
Health and Human Development Maternal-Fetal Medicine Units Network. Elective
repeat cesarean delivery compared with spontaneous trial of labor after a prior
cesarean delivery: a propensity score analysis. Am J Obstet Gynecol. 2012
Apr;206(4):311.e1-9. doi: 10.1016/j.ajog.2012.02.002. PMID: 22464069; PMCID:
PMC3337034.
29. Quinney SK, Mohamed AN, Hebert MF, Haas DM, Clark S, Umans JG, Caritis SN,
Li L. A Semi-Mechanistic Metabolism Model of CYP3A Substrates in Pregnancy:
Predicting Changes in Midazolam and Nifedipine Pharmacokinetics. CPT
Pharmacometrics Syst Pharmacol. 2012 Sep 26;1:e2. doi: 10.1038/psp.2012.5.
PMID: 23835882; PMCID: PMC3603475.
30. Johnson LH, Mapp DC, Rouse DJ, Spong CY, Mercer BM, Leveno KJ, Varner MW,
Iams JD, Sorokin Y, Ramin SM, Miodovnik M, O'Sullivan MJ, Peaceman AM, Caritis
SN; Eunice Kennedy Shriver National Institute of Child Health and Human
Development Maternal-Fetal Medicine Units Network. Association of cord blood
magnesium concentration and neonatal resuscitation. J Pediatr. 2012
Apr;160(4):573-577.e1. doi: 10.1016/j.jpeds.2011.09.016. Epub 2011 Nov 4. PMID:
22056282.
31. Caritis SN, Sharma S, Venkataramanan R, Rouse DJ, Peaceman AM, Sciscione A,
Spong CY, Varner MW, Malone FD, Iams JD, Mercer BM, Thorp JM Jr, Sorokin Y,
Carpenter M, Lo J, Ramin S, Harper M; Eunice Kennedy Shriver National Institute of
Child Health and Human Development Maternal-Fetal Medicine Units Network.
Pharmacokinetics of 17-hydroxyprogesterone caproate in multifetal gestation. Am J
Obstet Gynecol. 2011 Jul;205(1):40.e1-8. doi: 10.1016/j.ajog.2011.03.028. Epub
2011 Mar 22. PMID: 21620357; PMCID: PMC3165062.
32. McClure CK, Catov JM, Ness RB, Schwarz EB. Lactation and maternal
cardiovascular disease among premenopausal women. American Journal of
Obstetrics and Gynecology. Am J Obstet Gynecol. 2012 Jul;207(1):46.e18.Epub2012May2. PMID:22727348. PMCID: PMC3383628 [Available on 2013/7/1].
47
33. Lee PC, Talbot EO, Roberts JM, Catov JM, Bilonick RA, Stone RA, Sharma RK, Ritz
B. Ambient Air Pollution Exposure and Blood Pressure Changes during Pregnancy.
Environ Res. 2012 Jul 24. [Epub ahead of print]. PMID:22835955. NIHMS: 457040
34. Reynolds SA, Roberts JM, Bodnar LM, Youk AO, Haggerty CL, Catov JM.
Newborns of preeclamptic women show evidence of sex-specific disparity in fetal
growth. Gend Med. 2012 Dec;9(6):424-35. PMID:23217566.
35. Catov JM, Lewis CE, Lee M, Wellons MF, Gunderson EP. Preterm Birth and future
maternal blood pressure, inflammation and intimal medial thickness: CARDIA study.
Hypertension. 2013 Mar;61(3):641-6. 2013 Jan 14. [Epub ahead of print].
PMID:23319540. NIHMS: 437093. PMCID: PMC3583341.
36. Scifres CM, Catov JM, Simhan HN. The impact of maternal obesity and gestational
weight gain on early and mid-pregnancy lipid profiles. Obesity (Silver Spring). 2013
Jul 12. [Epub ahead of print]. PMID:23853155.
37. Facco FL, Ouyang DW, Zee PC, Grobman WA. Development of a pregnancyspecific screening tool for sleep apnea. J Clin Sleep Med. 2012 Aug 15;8(4):389-94.
doi: 10.5664/jcsm.2030. PMID: 22893769; PMCID: PMC3407257
38. Hutcheon JA, Platt RW, Abrams B, Himes KP, Simhan HN, Bodnar LM. A weightgain-for-gestational-age z score chart for the assessment of maternal weight gain in
pregnancy. Am J Clin Nutr. 2013 May;97(5):1062-7. doi: 10.3945/ajcn.112.051706.
Epub 2013 Mar 6. PMID: 23466397; PMCID: PMC3625243.
39. Himes KP, Koppes E, Chaillet JR. Generalized disruption of inherited genomic
imprints leads to wide-ranging placental defects and dysregulated fetal growth. Dev
Biol. 2013 Jan 1;373(1):72-82. doi: 10.1016/j.ydbio.2012.10.010. Epub 2012 Oct 17.
PMID: 23085235; PMCID: PMC3508140.
40. Bell MJ, Roberts JM, Founds SA, Jeyabalan A, Terhorst L, Conley YP. Variation in
endoglin pathway genes is associated with preeclampsia: a case-control candidate
gene association study. BMC Pregnancy Childbirth. 2013 Apr 1;13:82. doi:
10.1186/1471-2393-13-82. PMID: 23548068; PMCID: PMC3651360.
41. Schreurs MP, Hubel CA, Bernstein IM, Jeyabalan A, Cipolla MJ. Increased oxidized
low-density lipoprotein causes blood-brain barrier disruption in early-onset
preeclampsia through LOX-1. FASEB J. 2013 Mar;27(3):1254-63. doi: 10.1096/fj.12222216. Epub 2012 Dec 10. PMID: 23230281; PMCID: PMC3574277.
42. Founds SA, Shi H, Conley YP, Jeyabalan A, Roberts JM, Lyons-Weiler J. Variations
in discovery-based preeclampsia candidate genes. Clin Transl Sci. 2012
Aug;5(4):333-9. doi: 10.1111/j.1752-8062.2012.00413.x. Epub 2012 May 15. PMID:
22883611; PMCID: PMC3419489.
43. Shalom-Barak T, Zhang X, Chu T, Timothy Schaiff W, Reddy JK, Xu J, Sadovsky Y,
Barak Y. Placental PPARγ regulates spatiotemporally diverse genes and a unique
metabolic network. Dev Biol. 2012 Dec 1;372(1):143-55. doi:
10.1016/j.ydbio.2012.08.021. Epub 2012 Aug 29.PMID:22967998
44. Donker RB, Mouillet JF, Chu T, Hubel CA, Stolz DB, Morelli AE, Sadovsky Y. The
expression profile of C19MC microRNAs in primary human trophoblast cells and
exosomes.Mol Hum Reprod. 2012 Aug;18(8):417-24. doi: 10.1093/molehr/gas013.
Epub 2012 Feb 29. PMID: 22383544
45. Scifres CM, Catov JM, Simhan HN. The impact of maternal obesity and gestational
weight gain on early and mid-pregnancy lipid profiles. Obesity (Silver Spring). 2013
Jul 12. doi: 10.1002/oby.20576. [Epub ahead of print] PMID: 23853155.
46. Stout MJ, Scifres CM, Stamilio DM. Diagnostic utility of urine protein-to-creatinine
ratio for identifying proteinuria in pregnancy. J Matern Fetal Neonatal Med. 2013
48
Jan;26(1):66-70. doi: 10.3109/14767058.2012.727048. Epub 2012 Oct 5. PMID:
23020712.
47. Wadhwa PD, Simhan HN, Entringer S, Buss C, Smith R, Hobel CJ, Farhana N,
Shimmin L, Hixson JE, Sing CF. Variation in the Maternal Corticotrophin Releasing
Hormone-Binding Protein (CRH-BP) Gene and Birth Weight in Blacks, Hispanics and
Whites. PloS One. 2012; 7(9):e43931. Epub 2012 Sept 11. PMID: 22984453;
PMC3439482.
48. Caritis SN, Simhan HN, Zhao Y, Rouse DJ, Peaceman AM, Scioscione A, Spong
CY, Varner MW, Malone FD, Iams JD, Mercer BM, Thorp JM Jr, Sorokin Y,
Carpenter M, Lo J, Ramin SM, Harper M; Eunice Kennedy Shriver National Institute
of Child Health and Human Development Maternal-Fetal Medicine Units Network.
Relationship between 17-hydroxyprogesterone caproate concentrations and
gestational age at delivery in twin gestation. Am J Obstet Gynecol. 2012
Nov;207(5):396.e1-8.doi:10.1016 /j.ajog. 2012.08.001. Epub 2012 Aug 6. PMID:
22959763; PMCID: 3484214; NIHMS: 405398
49. Parry S, Simhan H, Elovitz M, Iams J. Universal maternal cervical length screening
during the second trimester: pros and cons of a strategy to identify women at risk of
spontaneous preterm delivery. Am J Obstet Gynecol. 2012 Aug; 207(2):101-6. Epub
2012 Apr 28. PMID: 22633270.
50. Society for Maternal-Fetal Medicine Publications Committee, with assistance of
Vincenzo Berghella. Progesterone and preterm birth prevention: translating clinical
trials data into clinical practice. Am J Obstet Gynecol. 2012 May; 206(5):376-86.
Erratum in: Am J Obstet Gynecol. 2013 Jan; 208(1):86 PMID: 22542113.
51. Caritis SN, Simhan H. Cervical pessary use and preterm birth: how little we know.
Lancet. 2012 May 12;379(9828):1769-70. Epub 2012 Apr 3. PMID 22475492.
52. Bream EN, Leppellere CR, Cooper ME, Dagle JM, Merrill DC, Christensen K,
Simhan HN, Fong CT, Hallman M, Muglia LJ, Marazita ML, Murray JC. Candidate
gene linage approach to identify DNA variants that predispose to preterm birth.
Pediatr Res. 2013 Feb; 73(2):135-41. doi: 10.1038/pr.2012.166. Epub 2012 Nov 20.
PMID: 23168575.
53. Gernand AD, Simhan HN, Klebanoff MA, Bodnar LM. Maternal Serum 25Hydroxygitamin D and measures of newborn and placental weight in a U.S.
multicenter cohort study. J Clin Endocrinol Metab. 2013 Jan; 98(1):398-404. doi:
10.1210/jc.2012-3275. Epub 2012 Nov 16. PMID 23162094; PMCID: 3537090.
54. Naresh A, Simhan H. Absence of viruses in amniotic fluid of women with PPROM: a
case series. J Reprod Immunol. 2012 Dec; 96(1-2):79-83. doi:
10.1016/j.jri.2012.08.003. Epub 2012 Sept 25. PMID: 23021256.
55. Entringer S, Epel ES, Lin J, Buss C, Shahbabab B, Blackburn EH, Simhan HN,
Wadhwa PD. Am J Obstet Gynecol. 2013 Feb; 208(2):134.e107. doi:
10.1016/j.ajog.2012.11.033. Epub 2012 Nov 27. PMID:23200710; PMCID: 3612534.
56. Hutcheon JA, Platt RW, Abrams B, Himes KP, Simhan HN, Bodnar LM. A weightgain-for-gestational-age z score chart for the assessment of maternal weight gain in
pregnancy. Am J Clin Nutr. 2013 May;97(5):1062-7. doi:10.3945/ajcn.112.051706.
Epub 2013 Mar 6. PMID: 23466397.
57. Speer PD, Canavan T, Simhan HN, Hill LM. Prenatal midtrimester fetal long bone
measurements and the prediction of small-for-gestational age fetuses at term. Am J
Perinatol. 2013 May 20. [Epub ahead of print]. PMID: 23690053.
58. Tomedi LE, Simhan HN, Bodnar LM. Early-pregnancy maternal vitamin D status and
maternal hyperglycaemia. Diabe Med. 2013 May 13. Doi: 10.1111/dme.12229 [Epub
ahead of print] PMID: 23668717.
49
59. Chang J, Streitman D. Physiologic adaptations to pregnancy. Neurol Clin. 2012
Aug;30(3):781-9. doi: 10.1016/j.ncl.2012.05.001. Epub 2012 Jun 30. Review. PMID:
22840789.
60. Bradley MS, Kaminski RJ, Streitman DC, Dunn SL, Krans EE. Effect of Rotation on
Perineal Lacerations in Forceps-Assisted Vaginal Deliveries. Obstet Gynecol. 2013
Jun 5. [Epub ahead of print] PMID: 23743462.
FACULTY LISTING
Hyagriv Simhan, M.D., M.S., Division Director, Division of Maternal Fetal Medicine
Sarah Bernstein, M.D., GME Fellow
Steve Caritis, M.D.
Jennifer Condon, Ph.D.
Christina Conway Pisani, M.D., GME Fellow
Nawal Beshara Cuddy, Dietician
Shareece Davis, M.D., Genetics Fellow
Francesca Facco, M.D.
Maisa Feghali, M.D., GME Fellow
Karen Florio, D.O., GME Fellow
Robin Gandley, Ph.D.
L. Wayne Hess, M.D.
Katherine Himes, M.D.
Carl Hubel, Ph.D.
Arun Jeyabalan, M.D.
Jacob Larkin, M.D.
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Devon Ramaeker, M.D., GME Fellow
Anne Rideout, CRNP
James Roberts, M.D.
Sara Sakamoto, M.D., GME Fellow
Christina Scifres, M.D.
David Streitman, M.D.
Kristina Yang Parviniainen, M.D.
Omar Young, M.D., GME Fellow
51
52
DEPARTMENT OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE SCIENCES
Joseph Sanfilippo, MD
Division Director
OVERVIEW
The Division of Reproductive Endocrinology and Infertility (REI) continues to achieve national
recognition for its accomplishments with respect to Fertility Preservation. The Fertility
Preservation Program-Pittsburgh (http://www.mwrif.org/220 ), is directed by Dr. Kyle Orwig in
coordination with Division Director Dr. Joseph Sanfilippo. In addition, a multispecialty
component includes faculty from adult and children’s sectors of UPMC. We are one of the most
comprehensive Fertility Preservation programs (FPP) in the country as we provide standard as
well as IRB approved experimental fertility preservation options for men, women, boys and girls.
We have received patients from across the nation. The program over the past academic year
has made a concerted effort to educate healthcare providers who are in any way involved in
management of individuals in the reproductive age group with a recent diagnosis of cancer or
other chronic debilitating disease necessitating chemotherapy and or radiation therapy and
desire to preserve their gametes for future fertility. The program includes:
Oocyte cryopreservation
Ovarian tissue cryopreservation
Fast track assisted reproductive technology/In vitro fertilization – embryo cryopreservation
Testicular tissue cryopreservation
Sperm cryopreservation
The FPP Program is indeed multi-specialty and includes UPMC related departments: Urology,
Hematology/Oncology-Pediatrics & Adult, Pediatric Surgery, Basic Sciences and the Division of
Gynecologic Oncology, all of whom participate in the FPP program under the direction of the
Division of REI. FPP enforces the recommendations of the American Society of Reproductive
Medicine (ASRM) as well as the American Society of Clinical Oncology (ASCO). The division
provides 24/7 services for fertility preservation and maintains a website
(http://www.mwrif.org/220) and a dedicated fertility phone line (412-641-7475) where patients
and their physicians can obtain information about fertility risks and options for preserving
fertility.
The core clinical faculty group of the Reproductive Endocrinology & Infertility Division is
composed of 5 Reproductive Endocrinologists, plus Generalist representation, the latter has
included expertise in Midlife and Gynecology as well as Pediatric and Adolescent Gynecology
and 3 Basic Scientists all of whom are well integrated into division activities. Clinical practice
subspecialties within the division continues to provide the most current education for the next
generation of physicians and physician scientists focused on Reproductive Endocrinology. Our
teaching program has expanded especially with regard to collaboration with the Division of
Adolescent Medicine within the Department of Pediatrics. Also the division over the past year
has expanded the surgical armamentarium especially with regard to robotics as applied to
Reproductive Endocrinology and Infertility.
Research endeavors continue to expand and represent coordinated care and focus toward
Translational Research as a reflection of the collaborative activity of clinicians and Basic Science
researchers within the division.
The Division houses the Editorial Office of the Journal of Pediatric and Adolescent Gynecology.
The journal is now ranked in the top 50th quartile among all journals in Obstetrics and
Gynecology and upper quartile among Pediatrics journals based upon the most recent Impact
Factor.
RESEARCH PROGRAMS
The research component in association with the Fertility Preservation Program-Pittsburgh (FPP)
over the past academic year has focused on direct differentiation of human pluripotent stem
cells into haploid spermatogenic cells. In addition, Dr. Orwig’s group achieved a major
breakthrough by demonstrating in a primate model that spermatogonial stem cell
transplantation can be used to treat male infertility (Hermann et al., Cell Stem Cell, 2013,
11:715-726). Working with Dr. Orwig was Dr. Gosia Skaznik-Wikiel (Gyn-Onc fellow), they
demonstrated that GCSF treatment can attenuate chemotherapy induced gonadal toxicity. Dr.
Dovey (REI Faculty) conducted research to assess the safety of spermatogonial stem cell
transplantation for cancer survivors by demonstrating that it is feasible to remove
contaminating cancer cells (Dovey et al., JCI 2013, 123:1833-1843. In addition, Dr. Dovey
obtained IRB approval for a “prospective outcomes” of pregnancies conceived with previously
frozen oocytes study and that research is ongoing. The FPP program and REI division’s faculty
and staff are active collaborators of the National Institutes of Health funded OncoFertility
Consortium and participate via the National Physicians Cooperative to Preserve Fertility for
Women and Girls with a Cancer Diagnosis.
One other area of both clinical and basic science research within the division, led by Dr. Marie
Menke, is focused on sexual dimorphic models of adipose tissue. Lipodystrophic models of
adipocyte turnover are also being studied. In tandem with this basic science research endeavor;
clinical research through the Longitudinal Assessment of Bariatric Surgery collaborative effort is
examining the effects of bariatric surgery on fertility and pregnancy outcomes. The REI division
will also initiate a research registry to facilitate observational research efforts and recruitment
for longitudinal studies.
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The REI Division works in close collaboration with the Midlife section of the Division of
Gynecologic Specialties. A number of accomplishments have occurred over the past academic
year that include research focused on “Yoga and quality of life in breast cancer survivors”, the
effects of yoga on bone health has also been conveyed in peer reviewed publications. In
addition, ongoing research has included a longitudinal epidemiologic analysis, SWAN (Study of
Women’s Health Across the Nation) analysis of mood and hormone metabolite concentrations.
The role of Melatonin and bone health, i.e. Menopausal Osteoporosis Prevention Study (MOPS)
has recently been published. Over the academic year, the division has added a certified
Acupuncturist with expertise in “Mind-body Connection”., Ms. Frances Desmone, has brought a
whole new perspective to provision of Holistic Medicine for Infertility as well as Oncology and
General Gynecology patients. Under her direction the array of acupuncture programs offered to
patients has undergone extensive expansion.
The division faculty continue to have multi-specialty collaboration with regard to sexually
transmitted infection prevention. Specifically, Robert Wood Johnson Foundation AMOS Medical
Faculty Development program (The Talking Village) has allowed collaborative efforts with
respect to healthcare education in young adults. The role of public schools and HIV prevention,
perspectives from African Americans in the rural south is collaborative work that is in press.
Ongoing research also addresses the relationship between adolescent weight, race and sexual
behavior. Within the REI Division, Dr. Aletha Akers has coordinated this effort.
Polycystic ovaries is a problem that effects up to ten percent of the population. In accord with
this reproductive endocrine problem multi-center collaborative research continues to be
accomplished. The role of metformin and clomiphene citrate in management of polycystic
ovarian syndrome as well as altering of hirsutism through ovulation induction in women with
polycystic ovary syndrome were two areas of concentration over the past academic year that
were presented in peer reviewed publications. In addition, in collaboration with the Eunice
Kennedy Shriver National Institute of Child Health and Human Development Cooperative
Reproductive Medicine Network, focused on endometrial shedding effect on conception and
live birth rate in women with polycystic ovarian syndrome was recorded by the REI network. Dr.
Gabriella Gosman has participated in this endocrinologic research.
Newly introduced research projects include; SonoHysterographic assessment of tubal patency in
comparison to hysterosalpingography (HSG). This prospective study is designed to compare the
efficacy of an ultrasonographic assessment of tubal patency in comparison to the “gold
standard” of Hysterosalpingography. Other research that has been initiated includes
assessment of premature leuteining hormone surge in fresh and frozen IVF cycles as well as a
collaborative research project with the Division of Genetics, studying the genetics of male
infertility. Retrospective assessment of hysteroscopic reciprocating morcellator for endometrial
polyps and submucous myoma resection has been finalized.
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The Reproductive Endocrinology and Infertility Division’s Basic Science Research segment
continues to expand well within the confines of our subspecialty, as detailed in the faculty
section below. Drs. Tony Plant and Anthony Zeleznik, hold joint appointments within the
Department of Obstetrics, Gynecology and Women’s Health within the Division of Reproductive
Endocrinology and Infertility, and the Department of Cell Biology & Physiology. Drs. Plant and
Zeleznik are recognized nationally and internationally for their reproductive physiology and
reproductive endocrinology studies in the nonhuman primate system. Most recently Dr. Tony
Plant and his cooperative team have focused on Sertoli cell differentiation in the Rhesus monkey
model with regard to early pubertal development. In addition, Follicle Stimulating Hormone
(FSH) signaling and its role with respect to azoospermia and infertile primate testis model has
recently been published. Dr. Zeleznik’s current research focuses on the mechanisms that
regulate FSH signaling in granulosa cells of developing follicles.
Dr. Kyle Orwig, Director of the Fertility Preservation Program in Pittsburgh, continues to conduct
research addressing spermatogonial stem cells in the testes that produce sperm. His research
ranges from fundamental investigations of mechanisms that regulate stem cell self-renewal and
differentiation in rodents, to preclinical development of the spermatogonial stem cell
transplantation technique in nonhuman primates, as well as translational investigations of
spermatogonial stem cells in human testes. On the female side, Dr. Orwig is investigating
compounds that protect the ovary against the damaging effects of chemotherapy. Clinical
Research within the REI Division is conducted in the Magee Clinical Research Center funded by
the satellite mechanism through the GCRC.
TEACHING PROGRAM
Pediatric and adolescent gynecology is an expanding segment of the REI Division, collaborative
efforts with the Department of Pediatrics, Division of Adolescent Medicine have offered a new
level of clinical service for the age range from neonate through young adult. Dr. Elizabeth
Miller, Division Director of Adolescent Medicine, in collaboration with the REI Division Director,
Dr. Joseph Sanfilippo and Drs. Aletha Akers and Serena Dovey have expanded the clinical and
consultative services at Children’s Hospital of Pittsburgh. The two divisions have worked
together to extend the depth and breadth of services. Specifically collaborative efforts with the
division of Pediatrics Surgery including fertility preservation, i.e. gonad cryopreservation in
prepubertal boys and girls has evolved over the past academic year; in addition expansion of
collaborative management in the realm of benign gynecological problems in the pediatric
adolescent age group has been one other accomplishment. The Pediatric Adolescent
Gynecology program provides a unique educational experience for residents in Obstetrics and
Gynecology as well as fellows in Reproductive Endocrinology and Infertility. A structured
educational program focused on specific goals and objectives that are to be completed for
residents on rotation in the division includes pediatric and adolescent gynecology.
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The Reproductive Endocrinology Infertility Fellowship remains extremely competitive. The
training at the University of Pittsburgh has a strong commitment to education in all aspects as
outlined by the American Board of Obstetrics and Gynecology (ABOG) with particular emphasis
in the surgical arena and in both basic science and clinical research. Over the past year
expansion of robotic training services including a robotic simulator has allowed us to be a leader
in reproductive endocrinology infertility surgical expertise. The basic science research aspect of
training is supervised by the REI Research Committee, comprised of clinical and research faculty,
which provides unique supervision and direction for REI fellows with regard to the ABOG
required research thesis. The REI program is a 3 year intense educational endeavor designed to
prepare the graduating fellow for a career in academic medicine.
ASSISTED TECHNOLOGY/IN VITRO FERTILIZATION PROGRAM
The Assisted Reproductive Technology/In Vitro Fertilization (ART/IVF) Program continues to be
the largest program in the region. Protocols focused on decreased ovarian reserve has allowed
many couples with significantly diminished ovarian reserve, the capability of achieving a
successful pregnancy Research in ART/IVF has addressed, serum progesterone levels during the
day of oocyte retrieval as a predictor of pregnancy outcome, i.e. a prospective cohort study.
The association between in-vitro fertilization outcomes in fresh versus frozen GnRH agonist
cycles for premature LH surge is an ongoing retrospective study. Dr. Anthony Wakim is Director
of the ART/IVF Program. Recent IVF statistics are as follows:
1. Exceed/Meet National Average for IVF Success National
<35 years of age
46.2%
35-37 years of age
38.5%
38-40 years of age
29.3%
41-42 years of age
19.5%
U Pitt
51.1%
38.5%
57.1%
28.6%
EDITORIAL OFFICE JOURNAL of PEDIATRIC & ADOLESCENT GYNECOLOGY
The REI division houses the editorial office for the Journal of Pediatric and Adolescent
Gynecology, at Magee-Womens Hospital. Recent notification with regard to the Journal impact
notes the rating to be “doubled” since awarding of the Impact Factor in 2009. This position
ranks the Impact Factor of the Journal of Pediatric and Adolescent Gynecology 51 among 107
journals of obstetrics and gynecology. The Journal is in its 26th year of publication and
continues to be well respected both nationally and internationally.
CLINICAL PROGRAMS
From the Clinical Services perspective, the REI Division has continued to grow with regard to
number of patients evaluated. A large majority of patients (50%) were evaluated for Infertility
and included Tubal Factor, Male Factor and “Unexplained” categories; 12% of patients had
decreased ovarian reserve. In line with national incidence, 10% of total patients evaluated had a
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diagnosis of Polycystic Ovarian Syndrome. Recurrent pregnancy loss accounted for 2% of total
number of patients evaluated.
IVF Cases
New Patients
Return Patients
2009
281
1389
2921
2010
322
1292
3083
2011
307
1403
3125
2012
362
1508
4033
Overall the spectrum of REI services include:
Acupuncture
Amenorrhea
Assisted Reproductive Endocrinology-In Vitro Fertilization
IVF-Intracytoplasmic Sperm Injection, Assisting Hatching,
Preimplantation Genetic Screening, Donor Oocyte, Donor Embryo
Donor Sperm Insemination
Endometriosis
Fertility Preservation
Hirsutism
Midlife (Menopause) Center
Minimally Invasive Reproductive Tract Surgery
Pediatric and Adolescent Gynecology
Polycystic Ovary Syndrome
Prolactin Disorders
Pubertal Disorders
Recurrent Pregnancy Wastage
Reproductive Tract Anomaly Treatment
Tubal Reanastomosis – Robotic Assisted
FACULTY
Joseph S. Sanfilippo, M.D. M.B.A. Professor, Department of Obstetrics, Gynecology and
Reproductive Sciences, The University of Pittsburgh School of Medicine, Director Division of
Reproductive Endocrinology and Infertility at Magee-Womens Hospital. Dr. Sanfilippo has been
a collaborator on work assessing paracrine and epigenetic control of trophectoderm
differentiation in human embryonic stem cells with emphasis on bone morphogenic protein 4
(BMP4) and histone deacetylases (HDACs). Dr. Sanfilippo also collaborated with Dr. Serena
Dovey, Dr. Kyle Orwig and coworkers in a study focused on differential antigen expression
allowing removal of malignant cells from therapeutic Spermatogonial Stem Cells (SSCs) via
Fluorescence-Activated Cell Sorting (FACS). This work was published in the Journal of Clinical
Investigation (Dovey et al., JCI 2013, 123:1833-1843). Other areas of research include
collaborative work with the division of Genetics focusing on the Genetic Basis of Premature
Ovarian Insufficiency. Dr. Sanfilippo is the principal investigator for the retrospective review on
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hysteroscopic intrauterine reciprocating morcellator, indications, complications and outcomes.
Sonohysterographic comparison to hysterosalpingography for tubal patency is a relatively
recently initiated clinical research project. The genetic basis of Mullerian anomalies is one other
collaborative effort with the Division of Genetics. Breast tumor markers and tumor progression
assessment is a collaborative effort with Dr. Shweta Nayak (REI Fellow) and Dr. Steffi
Oesterreich from the Department of Pharmacology and Chemical Biology.
Dr. Sanfilippo is the Director of the Reproductive Endocrinology and Infertility Fellowship
Training Program. He also serves as site inspector for Minimally Invasive Gynecologic Fellowship
(FMIGS) training programs under the auspices of the American Association of Gynecologic
Laparoscopists and the Society of Reproductive Surgeons – the American Society for
Reproductive Medicine. He is Editor-In-Chief of the Journal of Pediatric and Adolescent
Gynecology.
Anthony Wakim, M.D. Clinical Professor, Department of Obstetrics, Gynecology and
Reproductive Sciences and Director of Assisted Reproductive Technologies (ART).
Dr. Wakim has focused on research encompassing serum progesterone levels during the day of
oocyte retrieval as a predictor of pregnancy outcome, a prospective cohort study. In addition,
the association between in-vitro fertilization outcomes in fresh versus frozen GnRH agonist cycle
for premature LH surge is an ongoing retrospective study that Dr. Wakim is conducting in
collaboration with Dr. Serena Dovey and Dr. Shruti Malik.
In addition research focused on Premature Rise in Luteinizing Hormone in the Absence of
Increased Progesterone Levels Detrimental to Pregnancy Outcome in GnRH Antagonist In Vitro
Fertilization Cycles was published reported this academic year.
Gabriella Gosman, M.D. Associate Professor and Vice Chair for Education, Department of
Obstetrics, Gynecology and Reproductive Sciences. Obstetrics and Gynecology Residency
Program Director, Associate Designated Institutional Official, UPMC Medical Education.
Dr. Gosman continues to provide a leadership role with regard to departmental education and
institutional graduate medical education. Dr. Gosman has focused on the department’s resident
education simulation program for minimally invasive surgery (laparoscopy, Robotic Surgery, and
hysteroscopy). She is a member of the National Working Group on Assessment Tool
Development for OB/GYN Residencies with the Council on Resident Education in Obstetrics and
Gynecology (CREOG), part of the American College of Obstetricians and Gynecologists.
Robert L. Collins, M.D. Associate Professor, Department of Obstetrics, Gynecology and
Reproductive Sciences.
Dr. Collins is an integral member of the Division of Reproductive Endocrinology and Infertility.
His clinical focus includes ART/IVF. He is actively involved in REI Fellowship education and
provides clinical services in the northern segment of Western Pennsylvania and eastern Ohio.
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Serena Dovey, M.D. Assistant Professor in the Department of Obstetrics, Gynecology and
Reproductive Sciences, within the division of Reproductive Endocrinology and Infertility.
She has also been on staff at Children’s Hospital of Pittsburgh. Dr. Dovey has been the primary
clinician focused on fertility preservation and has served as the Clinical Director of the Fertility
Preservation Program in Pittsburgh. She has provided educational programs for clinicians
dealing with patients in the reproductive age group.. Her specific area of interest has focused on
ovarian reserve in girls and young women exposed to chemotherapy to determine if there are
clinically available assessment testing methods that would predict the degree of ovarian damage
induced with chemotherapy regimens and to determine whether future fertility impairment can
be predicted. Dr. Dovey, in collaboration with Dr. Wakim, completed research addressing
premature rise in luteinizing hormone in the absence of increased progesterone levels having a
detrimental effect on pregnancy outcome in GnRH Antagonist in-vitro fertilization cycles. Dr.
Dovey relocated to the University of Denver, Department of Obstetrics and Gynecology at the
end of the academic year.
Aletha Akers, M.D., M.P.H. Assistant Professor with the Department of Obstetrics, Gynecology
and Reproductive Sciences. In addition, she is on the clinical faculty of the Division of
Adolescent Medicine in the Department of Pediatrics at the University of Pittsburgh School of
Medicine.
Dr. Akers is a core faculty in the Center for Family Planning Research at the University of
Pittsburgh and a clinical scholar at the Clinical & Translation Science Institute, University of
Pittsburgh School of Medicine. She is an affiliated faculty in the Program for Research on Media
and Health at the University of Pittsburgh. Her research examines how social contextual factors
affect adolescent sexual decision making. Her current grant support includes the Robert Wood
Johnson Foundation, AMOS Medical Faculty Program. She is Principal Investigator on an NICHD
funded R21 grant examining the relationship between adolescent weight and sexual behavior.
Dr. Akers is co-investigator on a NIDA R01 funded LEAP Study that examined endemic HIV risk
behaviors among adolescents and on NICHD R21 study examining the relationship between
race, contraceptive behavior, and unintended pregnancy. Dr. Akers’ most recent contributions
to the literature have looked at the role of public schools in HIV prevention; perspectives from
African American’s in the rural south and AIDS education and prevention. In addition, she is the
first author on collaborative work addressing a qualitative study of rural African American
adolescents’ perspectives on primary STD prevention strategies.
Dr. Akers provides
gynecological services to adult and pediatric patients.
Marie Menke, M.D, M.P.H. Assistant Professor, Department of Obstetrics, Gynecology and
Reproductive Sciences.
Dr. Menke is investigating the effects of lipids and lipid metabolism in reproductive health
through the NIH K12 Women's Reproductive Health Research (WRHR) Career Development
grant mechanism. Under the mentorship of Dr. Erin Kershaw, this investigation focuses on
60
physiologic and pathologic (lipotoxic) effects of lipids in infertility and oocyte development. Dr.
Menke is in collaboration with members of the Longitudinal Assessment of Bariatric Surgery to
investigate the effects of bariatric surgery on fertility and pregnancy outcomes. She is the
principal investigator of the Center for Fertility and Reproductive Endocrinology Research
Registry; a registry designed to facilitate retrospective reviews and recruitment for longitudinal
studies.
Kyle E. Orwig, Ph.D. Associate Professor in the Departments of Obstetrics, Gynecology and
Reproductive Sciences and Developmental Biology, Director of REI Research, Director of the
Fertility Preservation Program, University of Pittsburgh School of Medicine.
Dr. Orwig is the founding director of the Fertility Preservation Program in Pittsburgh
(http://www.mwrif.org/220). He works closely with Dr. Sanfilippo as well as other physicians in
the division to educate patients and physicians about the reproductive consequences of
chemotherapy and radiation treatments and options for preserving fertility. Regarding basic
sciences research, Dr. Orwig studies the regulation of spermatogonial stem cells, which are
responsible for sperm production. His lab is pioneering stem cell based therapies for treating
male infertility. In addition, he collaborates with colleagues inside (Dr. Gerald Schatten) and
outside (Drs. A. Clark, UCLA; and Renee Reijo-Pera, Stanford) the Pittsburgh community to
differentiate pluripotent stem cells into spermatogonial stem cells or haploid gametes that
might be used for reproductive purposes. He is working with fellows in the REI division to
examine the safety of spermatogonial stem cell transplantation for cancer survivors (Dr. Dovey,
and the use of thalidomide (Dr. Ochalski-REI Fellowship graduate) and GCSF (Dr. Skaznik-Wikiel)
to protect the ovaries against the damaging effects of chemotherapy. All three of these studies
received national recognition when the fellows were invited to give platform presentations at
the American Society for Reproductive Medicine and the Society for Gynecologic Investigation
annual meetings. The REI division provides the ideal infrastructure for Dr. Orwig to translate
fundamental discoveries from the lab bench to the clinic particularly as it pertains to fertility
preservation patients. During the past year, Dr. Orwig’s research has been funded by R01 (PI:
Orwig) and U54 (subcontracted from Dr. Reijo-Pera) grants from the Eunice Kennedy Shriver
National Institute for Child Health and Human Development, the Unites States-Israel Binational
Science Foundation, the Richard King Mellon Foundation and the Magee-Womens Research
Institute and Foundation.
Tony M. Plant, Ph.D. Professor in the Departments of Obstetrics, Gynecology and Reproductive
Sciences and Cell Biology and Physiology, Director of Fellowship Research in Reproductive
Endocrinology and Infertility, Director of the Center for Fertility and Reproductive
Endocrinology, University of Pittsburgh School of Medicine.
As the Director of REI Fellowship Research, Dr. Plant oversees thesis development and progress
for the fellows. Two areas of research are being pursued by Dr. Plant. The first is directed at
elucidating the neurobiological mechanisms that govern the ontogeny of pulsatile GnRH
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secretion throughout development in the monkey, and that therefore dictate the timing of
onset of puberty in this species. Currently, the notion that the pubertal resurgence of pulsatile
GnRH release is triggered by an increase in hypothalamic KiSS-1 expression and GPR54 signaling
in association with a structural remodeling of hypothalamic neural networks is being pursued.
The second interest of research activities focuses on the developmental mechanisms underlying
the spermatogenic ceiling of the adult testis. Proliferation and survival of Sertoli cells and
undifferentiated (male germline stem cells) and differentiated spermatogonia in the monkey
testis are being examined using cellular and imaging techniques in collaboration with other
groups within the Center for Research in Reproductive Physiology (CRRP). Dr. Plant directs the
CRRP (http://www.crrp.pitt.edu/). During the past year, Dr. Plant’s research has been
supported by an R01 (grant) from the Eunice Kennedy Shriver National Institute for Child Health
and Human Development and the Magee-Womens Research Institute and Foundation.
Tony Zeleznik, Ph.D. Professor in the Departments of Obstetrics, Gynecology and Reproductive
Sciences and Cell Biology and Physiology, University of Pittsburgh School of Medicine.
Dr. Zeleznik is one of the world’s foremost experts in ovarian physiology and reproductive
endocrinology and therefore is an outstanding resource for resident and fellow training in REI.
The principal focus of research in Dr. Zeleznik’s laboratory is to understand the physiology and
cell biology of ovarian cyclicity (follicular development and selection, luteinization and
luteolysis) during the primate menstrual cycle. At the physiological level, they are using
macaque monkeys to investigate the in vivo response of the ovaries to standardized infusion
regimens of follicle stimulating hormone and luteinizing hormone in the presence and absence
of exogenous putative autocrine/paracrine agents such as insulin, insulin-like growth factor,
testosterone, activin and other members of the TGF-beta family to determine if any or all of
these putative non-gonadotropic regulators of ovarian function have demonstrable effects on
the ovary in vivo. At the cellular and molecular levels, Dr. Zeleznik’s lab is interested in
identifying the cellular signaling pathways used by FSH and LH to promote granulosa cell
proliferation and differentiation. During the past year, Dr. Zeleznik’s research has been
supported by an R01 grant from the Eunice Kennedy Shriver National Institute for Child Health
and Human Development.
Faculty Listing
Joseph S. Sanfilippo, M.D., MBA-Division Director
Gabriella G. Gosman, M.D.-Residency Program Director
Anthony Wakim, M.D.-Medical Director In Vitro Fertilization Program
Kyle Orwig, Ph.D.-Director of REI Research, Director of the Fertility Preservation Program
62
Tony Plant, Ph.D.-Director of REI Fellowship Research
Serena Dovey, M.D.-Clinical Director Fertility Preservation Progam
Aletha Akers, M.D.
Robert Collins, M.D.
Marie Menke, M.D.
Tony Zeleznik, Ph.D.
Fellows:
Matrika Johnson, M.D.,First year REI Fellow
Shruti Malik, M.D., Second year REI Fellow
Shweta Nayak, M.D., Third year REI Fellow
Past Fellows:
Melanie Ochalski, M.D.
Serena Dovey, M.D.
Teresa Erb, M.D.
Thesis
Defense Date
1/30/12
5/31/11
9/24/10
Current Postion
The Fertility Center, LLC, York, PA
Assistant Professor, University of Colorado
RHS, Reproductive Health Specialists, Pittsburgh, PA
WEBSITE: http://obgyn.medicine.pitt.edu/infertility/
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DIVISION REPRODUCTIVE GENETICS
DIVISION OF REPRODUCTIVE GENETICS
Aleksandar Rajkovic, MD, PHD,
Division Director
OVERVIEW
The Division of Reproductive Genetics provides genetic counseling and clinical evaluation to
individuals who are concerned about their genetic background and the possible effect it may
have on their health or reproductive future. The Division's research is focused in a number of
areas: non-invasive methods of screening for Down syndrome and other chromosomal
abnormalities in pregnancy, mechanisms of cancer predisposition, new approaches for fetal
genotyping, the etiology of recurrent pregnancy loss, genetics of premature ovarian failure,
menopause, leiomyomas, ovarian cancer, and utility and design of chromosomal microarrays in
use on constitutional and cancer genetics.
RESEARCH PROGRAMS
The Division of Reproductive Genetics and Genomics provides clinical evaluation and genetic
counseling to men and women with genetic/genomic disorders, including preconceptional,
prenatal, adult and cancer cases. The division is also involved in the diagnosis and management
of fetal structural birth defects through the Fetal Diagnosis and Treatment Center. The division
offers cutting edge genetic/genomic testing and result interpretation. Another important
mission of our division is to provide education to medical students, residents, and various
subspecialty fellows including medical genetic and maternal fetal-medicine fellows. Research
within the division encompasses a number of important topics including: non-invasive methods
for fetal genomic diagnoses, development of algorithms for whole genome analyses,
mechanisms of cancer predisposition, the etiology of recurrent pregnancy loss and aneuploidies,
genetics of premature ovarian failure, menopause, male infertility and leiomyomas, as well as
the utility and design of chromosomal microarrays for use on constitutional and cancer genetics.
RESEARCH PROGRAMS
Dr. David Peters studies the utility of high-throughput sequencing and development of
sophisticated algorithms to determine in utero whether baby is affected by aneuploidy or
submicroscopic chromosomal imbalances. His group is NIH funded to recruit and validate their
65
methodology in the clinical setting of the Magee Womens Hospital of UPMC. Dr. Peters is also
interested in the functional genomics of complex phenotypes and is currently involved in a
collaboration with members of the Division of Endocrinology to characterize the influence of
epigenomic regulation of gene expression in diet induced obesity. Dr. Peters group has
developed core expertise in high-throughput DNA sequencing and associated computation. Dr.
Peters’ laboratory houses an Illumina HiSeq 2500 and Dr. Peters and staff provide core services
for DNA sequencing for MWRI/MWH investigators and other colleagues.
Dr. Svetlana Yatsenko studies the utility of chromosomal microarrays in prenatal diagnosis. The
superior resolution of chromosomal arrays can detect genomic imbalances as small as a few
thousand base pairs. Their studies show that it augments regular karyotype by approximately
10% in cases of ultrasound-detected anomalies. Dr. Yatsenko has also developed a high
resolution X chromosome array (with a resolution of few hundred base pairs) that can be
utilized to study X-linked disorders and can be used as a research tool to study the contribution
of the X chromosome to sex determination disorders and ovarian failure. She also developed a
comprehensive cancer array that can be utilized to study genomic imbalances in hematologic
cancers. Her preliminary data show superiority of her arrays over classical karyotype in detecting
genomic imbalances with additional findings in more than 50% of cases.
Dr. Alex Yatsenko focuses on the genetics of male infertility. He is utilizing cytogenomic and
whole exome/genome sequencing approaches to understand causes of male infertility and
subfertility. He closely collaborates with members of the Division of Reproductive Endocrinology
and Infertility as well as members of the Department of Urology. Dr. Yatsenko discovered novel
UBE2B RNA mutations in infertile men with oligozoospermia, as well as contribution of
numerous other genes to causation of male infertility. He also works on sperm RNA biomarkers
that could be utilized in predicting fertilization outcomes in infertile men.
Dr. Judith Yanowitz is specifically interested in meiotic crossover recombination as a major
determinant of chromosome mis-segregation during the formation of eggs and sperm. Her
research is directly relevant to the etiology of aneuploidy in humans as well as the age of
menopause. The Yanowitz lab is funded by NIH to study a novel checkpoint system that
monitors whether each chromosome receives the crossover and delays progression through
meiosis to allow more time for crossovers to be made. Dr. Yanowitz also focuses efforts on the
relationship between meiotic crossover formation and the repair of normal double strand
breaks, and this work has a strong potential to extend beyond germ line development into
mechanistic studies of processes that underlie cancer progression.
Dr. Marta Kolthoff has research interests in the areas of assisted reproduction, genetics, and
bioethics. She received a $14,000 grant through the Volunteer Service Board at Magee-Womens
Hospital of UPMC. This grant funds the “Perinatal Care Program” that provides resources for
patients and families who receive a prenatal diagnosis of a birth defect, genetic condition or
fetal demise. She will use these resources to better optimize care and recovery of families
affected by loss.
Dr. Jie Hu is interested in identification of genes that associate with multiple congenital
anomalies, dysmorphic features and neurodevelopmental disorders. She combines
cytogenomic arrays with conventional chromosome analysis and fluorescence in situ
66
hybridization, to study genomic copy number (CNV) alterations linked to certain traits, which
can effectively investigate candidate genes in a large cohort of individuals with specific CNVs
and lead to phenotype and genotype correlations.
Dr. Tianjiao Chu is interested in the development of statistical tools for non-invasive prenatal
diagnosis using next generation sequencing data. Dr. Chu developed two statistical algorithms to
determine, based on the DNA sequencing data of a mixture of DNA fragments from two
genomes, whether abnormal copy number variations occur in one of the two genomes. In
collaboration with Dr. Peters, these algorithms have been successfully applied to the noninvasive prenatal aneuploidy diagnosis using maternal plasma DNA sequencing data. Dr. Chu
also collaborates with Drs. Sadovsky and Mouillet, thru NIH funded grants, to develop
computational/statistical tools to study the function of microRNAs in human placenta, in
particular, the targets of miRNAs, and to discover the comprehensive genomic regulatory
network in human placenta involving miRNAs, mRNAs, and proteins.
Dr. W. Allen Hogge has a long-standing interest in recurrent miscarriages and specifically the
genetics of miscarriages in chromosomally normal conceptions.
Dr. Devereux N. Saller, Jr. has a long-standing interest in prenatal diagnosis and management of
fetal structural birth defects. He is especially interested in the applications of non-invasive
prenatal testing to high risk and low risk pregnancies, and establishing new guidelines for
prenatal genetic/genomic screening.
Dr. Aleksandar Rajkovic is interested in both prenatal and gynecologic genomics. The Rajkovic
laboratory is utilizing whole exome/genome sequencing to determine genetic causes of
structural birth defects in utero. Moreover, his group is utilizing genomic tools thru NIH funded
studies to understand genetic causation of premature ovarian failure and uterine fibroids. His
group discovered several important genes involved in premature ovarian failure and determined
that Med12 mutations are present in almost 70% of leiomyomas isolated from American
women. He has also interest in developing small molecule inhibitors to regulate reproductive life
span and contraception.
Members of the Division of Reproductive Genetics authored or co-authored 28 publications
for the 2012-2013 academic year.
TEACHING PROGRAMS
The Division is active in resident, medical student and graduate student teaching. Second year
residents in obstetrics and gynecology rotate through the Division as part of their
Ultrasound/Genetics Block. Drs. Hogge and Saller are course directors for the 4th year elective
in clinical genetics. Drs. Yanowitz and Rajkovic lectured for the newly developed Reproductive
Development Course. Dr. Yanowitz is co-Director of the course and plans to offer this course
yearly to undergraduate, graduate students and clinical fellows. Drs. Hogge, Svetlana Yatsenko
and Rajkovic also teach genetic counselors, graduate students and fellows in the Human
Genetics course. Members of the Division are also involved in teaching Molecular Genetics and
Cytogenetic Laboratory Fellows.
67
Microarray Case Conference is offered on a monthly basis for CME credits and broadcast by
video link to Children’s Hospital of Pittsburgh. Cytogenomic cases of interest are discussed in
depth to an audience consisting of clinical care providers, physicians, genetic counselors,
laboratory personnel, residents, medical students and fellows.
Whole Exome Sequencing Conference addresses whole exome/genome sequencing efforts and
analysis in clinically challenging cases. Whole exome sequencing cases of interest are discussed
in depth to an audience consisting of clinical care providers, physicians, genetic counselors,
laboratory personnel, residents, medical students and fellows.
Magee Clinical Genetic Meeting occurs weekly in which patient care, cases, and pertinent
publications are reviewed and discussed in depth.
FDTC Meeting occurs weekly with discussions of fetal diagnosis, management and treatment in
multidisciplinary setting.
FELLOWSHIP
The Division has a two-year fellowship program in Medical Genetics and offers two positions per
year. This fellowship program is offered in conjunction with the Division of Medical Genetics at
Children’s Hospital of Pittsburgh. The program focuses on providing broad educational
experience that ranges from conception thru adulthood and spans preconceptional, prenatal,
dysmorphology, adult, cancer and biochemical genetics. A broad base of clinical and laboratory
training is offered. Dr. Pankaj Thakur and Dr. Shareece Davis (combined MFM-Genetics fellow)
graduated in 2013. Current clinical fellows are Dr. Melanie Leu and Dr. Henry Joel Mroczkowski.
The current cytogenetic fellow is Dr. Jess Peterson.
CLINICAL PROGRAMS
Clinical programs within the Division encompass both direct patient care and laboratory
evaluation. The direct patient care services are as follows:
Prenatal Counseling, Fetal Diagnosis and Treatment Center (FDTC), Adult and Cancer Genetics,
Teratogens/Telephone Consultations. There were 12,240 visits in this category reflecting a 12%
increase over FY12. Much of this increase can be attributed to an increased emphasis on cystic
fibrosis screening and First Trimester Screening for Down syndrome, as well as increased
utilization of DNA based screening methods for aneuploidy.
Fetal Diagnosis and Treatment Center coordinates the efforts of various specialties, including
genetics, ultrasound, maternal-fetal medicine, neonatology, and pediatric subspecialty services
to evaluate and manage pregnancies identified with birth defects. In FY13 there were 705
patient visits through the FDTC. The fetal therapy program continues to expand in both volume
and scope, now with the capacity to perform a complete complement of in utero procedures
from ultrasound-guided fetal interventions such as intrauterine transfusion, to fetoscopic
procedures such as laser photocoagulation for twin-twin transfusion syndrome, to open fetal
surgery for repair of myelomeningocele. The FDTC is a major training venue for genetics and
maternal-fetal medicine fellows, and it serves as an excellent source for clinical and basic
science research opportunities for residents and fellows.
68
Pregnancy Screening Laboratory (PSL) performs on site Quad Screen (alpha fetoprotein, human
chorionic gonadotropin, unconjugated estriol, and inhibin A), amniotic fluid AFP measurements,
and amniotic fluid acetylcholinesterase. The PSL also performs first trimester screening using
nuchal translucency, pregnancy associated plasma protein A and human chorionic
gonadotropin. In FY13 a total of 8,505 tests were performed, an increase of 6% from the
previous year.
Pittsburgh Cytogenetics Laboratory (PCL) serves as the reference laboratory for the UPMC
system and for a number of hospitals in the tri-state area. Services include: 1) high quality
chromosomal analysis on amniotic fluid, chorionic villus samples (CVS), peripheral blood, cord
blood, bone narrow, lymph node, skin biopsy, malignant tumors and products of conception; 2)
molecular cytogenetic analyses by fluorescence in situ hybridization (FISH) for aneuploidy,
microdeletion/microduplication syndromes, marker chromosome identification, translocation
characterization, subtelomere rearrangement, Her2/neu amplification and mosaicism screening;
3) microarray analyses (CGH+SNP, X-HR) for DNA copy number alteration and constitutional
uniparental disomy on pediatric, prenatal/adult samples and samples from products of
conception. The PCL is also accredited by American Board of Medical Genetics for clinical
cytogenetics fellowship training. In FY13 a total of 15,891 tests were performed, which
represents a 2% increase over the previous year. The laboratory has begun to perform
chromosomal microarrays over the past two years, and performed over 1,700 chromosomal
microarrays in FY13. We brought microarray analysis for prenatal diagnosis in house in 2013,
offering a combination SNP/oligonuculeotide platform. Please refer to http://pittgenetics.com
for the full array of our services.
FACULTY LISTING
Aleksandar Rajkovic, M.D., Ph.D.
W. Allen Hogge, M.D.
Devereux N. Saller, Jr., M.D.
David Peters, Ph.D.
Jie Hu, M.D., Ph.D.
Marta Kolthoff, M.D.
Judith Yanowitz, Ph.D.
Alexander Yatsenko, M.D., Ph.D.
Svetlana Yatsenko, M.D., Ph.D.
Tianjiao Chu, Ph.D.
CLINICAL FELLOWS
Joel Mroczkowski, M.D. Ph.D.
Melanie Leu, M.D.
69
Jess Peterson, M.D.
WEBSITE:
http://obgyn.medicine.pitt.edu/genetics/
70
DIVISION ULTRASOUND
DIVISION OF ULTRASOUND
OVERVIEW
Lyndon M. Hill, MD
Division Director
The mission of the ultrasound division is to:



Provide quality obstetric and gynecologic ultrasound services in a timely and costeffective manner;
Continue to improve the resident/fellow ultrasound rotation in order to nurture the
development of future obstetric and gynecologic sonologists;
Develop an active research program that contributes to the knowledge of the specialty
and provide a stimulus for the academic growth of young faculty.
Members of the division are recognized locally and nationally for their expertise in obstetric and
gynecologic sonography. Hence, patients with complicated or abnormal ultrasound examinations
are frequently referred for consultation.
The major success of the ultrasound division is its acknowledged quality in performing obstetric
and gynecologic ultrasound examinations. The goals of the division are to improve our services
so that patient and referral physician satisfaction is commensurate with the quality of the service
provided.
In 1996, the division was among the first ultrasound facilities to be accredited by the American
Institute of Ultrasound in Medicine for obstetrical and gynecologic ultrasound. The accrediting
process evaluates equipment use and maintenance; report generation; storage of images; and
sonographer and physician qualifications. In general, the accreditation process will improve the
quality of ultrasound services. The number of private practices choosing to perform ultrasound
examinations in their offices will inevitably decline. If we can continue to recruit staff as needed,
we will be well positioned to take advantage of this natural centralization of ultrasound services.
The challenges in medical practice have provided the division with the opportunity to develop a
new model for patient care that seeks to expand our patient base, while improving ultrasound
services in the Community. This model has five critical components:
1.
A program of sonographer training whether at Magee or on-sight.
71
DIVISION ULTRASOUND
2.
3.
4.
5.
Establishment of specific protocols for each exam.
Instillation and training in our web-based Ultrasound Information System.
Stentor transmission of images to Magee.
Around-the-clock availability for the interpretation and preliminary report generation by
our staff.
To date, this model has been implemented in 5 sites.
In the past year one of our goals has been a continued improvement in patient satisfaction by
reducing the wait time for each examination. Despite our increasing volumes, we have managed
to markedly improve the percent of patients whose exam is started within 30 minutes of the
patient arriving in the department [see graph].
Division of Ultrasound
72
DIVISION ULTRASOUND
CLINICAL PROGRAM
The ultrasound division saw 71,000 obstetric/gynecologic patients in the FY12.
Over the past year Dr. Stephen Emery has begun to expand the Fetal Diagnosis and Treatment
Center from a primarily diagnostic/consultative service, to one that is involved in direct fetal
therapy. Placental laser for twin-to-twin transfusion; radio frequency ablations; and cardiac
valvular dilatation for critical left or right ventricular stenosis are three of the procedures that are
being offered at Magee-Womens Hospital.
Because of our expanded services, the division hired a sonographer, Tonya Lightcap, to assist
with patient evaluation, as well as fetal procedures.
TEACHING PROGRAM
The training of residents and fellows is a major commitment of the division. In addition to
obstetric and radiology residents, fellows in Maternal-Fetal Medicine, Genetics and Fetal Imaging
rotate through the division. The Maternal-Fetal Medicine fellowship rotation has recently been
expanded to 5-6 months of hands-on scanning, evaluation of interesting cases and weekly
conferences on fetal anomaly detection. In addition, a web site has been developed that
incorporates clips and images of fetal anomalies for the fellows to review.
st
The obstetric residency training program has also been expanded and now includes both 1 and
nd
2 year residents. The residents’ training includes a combination of hands-on training, as well
as didactic lectures on specific everyday ultrasound examinations and procedures.
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DIVISION ULTRASOUND
Division of Ultrasound
In order to ensure a sufficient number of sonographers, the department is also involved in training
technicians from two local sonography programs.
A full-time experienced sonographer has been hired in order to coordinate the teaching goals of
the division.
RESEARCH PROGRAM
The research interests of the division span the field of obstetrics and gynecologic ultrasound.
Recent studies include the assessment of amniotic fluid in monoamniotic twins and the role of a
rd
short femur length in the second trimester in the detection of 3 trimester growth restriction.
Over 20 web-based programs spanning topics from the biophysical profile score and
oligohydramnios to ectopic pregnancy and the sonographic evaluation of adenomyosis have been
produced in association with the Institute of Advanced Medical Education.
The division continues to participate in national studies with a focus on specific maternal
conditions that affect fetal health. In 2008 the division completed the CAPPS [Combined
Antioxidants in Pre-eclampsia Prediction Studies] Study in which we evaluated the role of uterine
artery Dopplers in the prediction of pre-eclampsia. Between 2008-2011 we participated in the
SCAN Trial [ A Randomized Trial of 17P Intervention of Preterm Birth in Nulliparous Women with
a Short Cervix] through the Maternal- Fetal Medicine Network by measuring cervical length in
nulliparous asymptomatic women.
The division currently participates in the NICHD NuMoM2B investigation. The NuMoM2B study
will follow nulliparous pregnancies into the neonatal period in an attempt to identify tests that may
be efficacious in the detection of high-risk pregnancies.
The division also joined NAFTNet (North American Fetal Therapy Network) in order to jointly
pursue our specific research interests in fetal surgery and congenital anomaly detection.
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DIVISION ULTRASOUND
FACULTY LISTING
Lyndon M. Hill, MD
Professor of Obstetrics, Gynecology and Reproductive Sciences
Division Director
Director of OB/Gyn Ultrasound
Co-director Maternal-Fetal Medicine
Jerry G. Martin, MD
Assistant Professor of Obstetrics, Gynecology and Reproductive
Sciences
David Kauffman, MD
Sciences
Bonnie Coyne, MD
Sciences
Stephen Emery, MD
Associate Professor of Obstetrics, Gynecology and Reproductive
Sciences
Paul Speer, MD
Sciences
Timothy Canavan, MD
Sciences
Marta Kolthoff, MD
Sciences
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DIVISION ULTRASOUND
Sciences
Tonya Lightcap, RDMS
Sonographer
WEBSITE: http://obgyn.medicine.pitt.edu/ultrasound
76
COMMUNITY SERVICES PRACTICE LINE
COMMUNITY PRACTICES SERVICE LINE
Edward Sandy, II, MD, MBA
Vice Chair, Community Practices
OVERVIEW
The academic year 2011-2012 was a year of continuing growth and integration for the
Community Practice Service Line. From its beginnings in 2008 the service line has grown to over
80 providers in more than 40 practice sites and 5 hospitals throughout Western Pennsylvania.
The mission of the Community Practice Service Line, developed at its first Strategic Planning
Session, is to “provide compassionate, quality integrated care in a community of practices which
continues to grow through a pairing of innovative technology and dedicated physicians and staff
who both value their patients and are valued by UPMC.” The service line has seen significant
growth in clinical activity, increasing interaction with subspecialty partners within the
department and continuing support of the academic mission of the department.
The clinical staff consists of 102 providers and a support staff of 330. Approximately 5,425 new
patients were seen, with another 59,600 return patient visits and nearly 6,750 deliveries. This
clinical activity resulted in patient charges of $109M. These clinical activities provided a robust
environment for medical students, residents, and fellows to not only learn from the patients
they served, but from the clinicians directly caring for these patients on the “front lines of
medicine.”
A Brief History
When UPMC acquired Mercy Hospital in 2008, it made a commitment to continue to provide
high quality health care for women, including obstetrical care. While the Department of
OB/GYN/Women’s Health had made an initial entrée into community practice support with the
practice of Robert Thompson and Morris Turner years earlier, the Mercy need for obstetrical
support represented a new challenge in a new venue with the added need to provide those
services within the framework of the Ethical And Religious Directives of the Catholic Church.
The Greater Pittsburgh OB/GYN and Metro OB/GYN practices were well established, full service
OB/GYN practices at Mercy, and bringing them into the department was a natural choice. By
77
July of 2008, the newly formed practices were the foundation of women’s health care at Mercy.
The academic year 2008-2009 was devoted to the successful integration of these practices into
the department and supporting the newly named UPMC-Mercy in its transition efforts.
The 2009-2011 academic year were ones of continued recruitment, partnering and expansion
for the service line. Growth in the service area and relocation of some providers out of the
Pittsburgh area allowed the GPOB practice to recruit new talent for their team. The closure of
the Ohio Valley Hospital (OVH) OB service provided an opportunity to partner with OVH and
expand into their market location, providing a new source of OB volume for Mercy hospital
while providing gynecologic consultation services for OVH. The decision of the West Penn
Allegheny Health System to consolidate their OB services at the West Penn location provided
additional opportunities for a new partnership. The Midwife Center for Birth and Women’s
Health, formerly utilizing Allegheny General Hospital as their referral center for hospital-based
obstetrics, decided on UPMC-Mercy and its OB providers as their choice for a new relationship
in Pittsburgh. Northpark Obstetrics and Gynecology had also utilized AGH for obstetrical
services, but after joining the division in 2009 their OB transitioned to Magee- Women Hospital,
and their gynecology to UPMC-Passavant. In January of 2010 the well regarded Womencare
Associates of Magee-Womens Hospital of UPMC joined the department, more than doubling the
size of the Community Practices Division. By July of 2010 the newly-designated Community
Practices Service Line was well positioned to be the community foundation of the department’s
clinical activities. In 2010-2011 the department acquired two community practices and
combined them to form Magee Womens Specialties at Northwest. The Department also added
new providers to increase patient access in several existing practices.
Clinical Program
The service line has seen an expansion in patient care, development of new clinical programs
and continuing quality and patient safety activities. The core clinical program is general OB/GYN
care, including routine and complex obstetrics, benign gynecology including minimally invasive
surgical techniques and office surgery, contraception, mid-life and well woman care. The
number of patients seen and services provided has grown substantially since 2008:
Service Type
Annual Exams
Consultations
New Visits
Post-op Visits
Return Visits
OB Deliveries
Charges
FY2010
FY2011
FY2012
FY2013
48,602
80,427
97,385
99,464
274
335
976
1,305
2,835
4,402
5,425
5,997
2,646
3,765
5,569
5,844
32,191
50,061
59,598
68,643
3,548
4,790
6,734
8,399
$46.62M
$75.72M
$97.5M
$106.6M
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Continuing the strategy of integrating existing practices and providers into the service line in
mission-critical areas, seven providers and their practices have been added, based at UPMC
Horizon and its two campuses. These practices increase our penetration along the northern I79/I-376 corridor.
This expansion provides further opportunity to develop and refine our departmental objective
of integrating academic and subspecialty services with our communities. Dr. Dan Edlestone
provides MFM services for patients at UPMC-Mercy, expanding on the subspecialty integration
initiated by GYN-Oncology. Dr. Wayne Hess provides Maternal-Fetal Medicine (MFM) and Erie
(Hamot) consultation at UPMC-Northwest and UPMC-Horizon. In addition, telemedicine
initiatives are in place and utilized by MFM at the Northwest campus. Dr. John Comerci and Dr.
Robert Edwards of GYN-Oncology and Dr. Robert Collins of Reproductive
Endocrinology/Infertility and Dr. Jonathan Shepherd of Urogynecology all maintain a strong
presence in these areas providing consultation and outpatient services at many of our
community sites.
One of the hallmarks of care in the department is the commitment to patient safety and quality.
Dr. Stephanie Nicholas continues as Medical Director for Patient Safety and Quality developing,
coordinating, and monitoring initiatives in the service line. Several projects focusing on
outpatient quality have been initiated in the Mercy Magee practices, and expansion to the
remaining practices will be expected.
Educational Program
As Clinical Faculty, the members of the service line take seriously their commitment to the
education of future providers. Members of the service line provide teaching for the following
groups:
1. Medical students of University of Pittsburgh School of Medicine
2. Visiting students from other institutions
3. Residents in Obstetrics, Gynecology and Reproductive Sciences
Teaching activities take place in community practice offices, inpatient units including Labor and
Delivery and the operating room. Some members also lead problem based learning groups, and
many provide instruction in the second-year Breast and Pelvic Examination sessions. The goal
of these efforts is to provide a “real world” environment to experience the presentation and
management of OB/GYN issues. Clinical issues in the community setting often require a different
approach than that of an academic medical center, and the faculty provides myriad examples of
surgical technique, case management and physician interaction with patients, colleagues and
staff.
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Strategic Planning
The rapid growth of the service line required thoughtful examination of both the assets
and direction of the practices. In the fall of 2010 the service line partnered with the
Lowder School of Business at Auburn University to develop a strategic analysis. Their
recommendations included:
1. Maximize the use of analytics.
2. Attract and retain highly qualified physicians and staff to help build longterm relationships with patients.
3. Address demographic shifts with new offerings.
4. Adopt a process improvement focus.
5. Improve the office and clinic environment to provide more comfort for
patients
6. Achieve greater integration with Department and affiliated UPMC facilities
and services
7. Greater expansion outside of the Pittsburgh Metropolitan Area
These topics and others were addressed at the first Community Practices Strategic Planning
Session held in April of 2011. During this one-day session, led by faculty from the Katz School of
Business, University of Pittsburgh, the thought leaders of the service line gathered with the
leaders of the department to consider these goals and how they integrate with the strategic
goals of the department and UPMC.
The service line’s four broad strategic goals are:
1. Community Practices will develop and maintain a satisfied and engaged workforce.
2. Community Practices will successfully integrate with their partners in the Department
of OB/GYN/RS and UPMC.
3. Community Practices will continuously improve organizational quality
4. Community Practices will continuously improve clinical quality and safety.
Future Growth and Development
The service line will continue to acquire practices as opportunities present, keeping
focus on the goal developing a premier OB/GYN integrated delivery system. The service
line will also become more involved in building the UPMC-Hamot Womens Health Program. The
integration of subspecialty services, especially maternal-fetal medicine, urogynecology, and
gynecologic oncology, will continue. Aware of the coming changes in health care delivery and
the need for appropriate resource utilization, the service line is in the process of a systematic
evaluation of all clinical site utilization, working toward appropriate, analytics-driven
consolidation or expansion, as appropriate. Enhancement of resident and student opportunities
will continue, and work will continue on the development of a PA “residency” in OB/GYN and a
Community OB/GYN rotation for our residents. Patient safety and quality programs will
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continue to expand, and the electronic medical record will be implemented in all of our
practices.
Practices
UPMC-Mercy
GPOB
David Badway, M.D.
Rocco Florio, D.O
Sondra Kapnadak, M.D.
Daniel Lattanzi, M.D.
Merridith Leggat, M.D.
Michael F. Lupinetti, M.D.
Satish Nayak, M.D.
Stephanie L. Nicholas, M.D.
Kiran Perkins, M.D.
David Rapkin, M.D.
Roberta Renzelli-Cain, D.O.
Ira Rock, M.D.
Sonyoung Seo-Patel, M.D.
Claver Soriano, M.D.
Michele Straka, D.O.
Nicole Waltrip, M.D.
Metro
David Deitrick, D.O.
Behrooz Khalili, M.D.
Hossein Noorbakhsh, M.D.
UPMC-Passavant
Northpark OB/GYN
Richard Zigrossi, M.D.
Stacey Carlitz
Bethany Hahn, M.D.
Dennis Krivinko, M.D.
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UPMC-Horizon
Magee Womens Specialties at Horizon
Jan Agnew, CNM
Rifat Basally, M.D.
Bradley Dennis, M.D.
Robert McFadden, M.D.
Christine Nagy, M.D.
Janet Segall, M.D.
Michelle Tate, M.D.
Michele Wright, D.O.
Magee Womens Hospital of UPMC
Womencare Associates
John Fisch, M.D.
Carey Andrew-Jaja, M.D.
Sharon Baer, D.O.
Michael Bummer, M.D.
Jamie Cannon, M.D.
Carole Chesin, M.D.
Stephen Corey, M.D.
Tabitha Delo, M.D.
Preeti Divekar, M.D.
April Dunmyre, D.O.
Kenneth Dzialowski, M.D.
Michael England, M.D.
Dennis English, M.D.
Suzanne Griffith, M.D.
Ari Heffman, M.D.
Amy Imro, M.D.
Renu Joshi, M.D.
Andrew Kellerman, M.D.
Mark Mallinger, M.D.
Kimberly Melen, M.D.
George Poutous, M.D.
Zenaida Rosado, M.D.
George Rosenberg, M.D.
Sandra Rygg, M.D.
Samuel Seiavitch, M.D.
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Elizabeth P. Seiders, M.D.
Evan Shikora, M.D.
Robert Simmonds, M.D.
Kitila Smith, M.D.
Deborah A. Sommer, M.D.
Robert Stern, M.D.
Lee Ann Swanson, M.D.
Harati Tatineni, M.D.
Deborah A. Whiteside, M.D.
NIA Obstetrics and Gynecology
Corrine Robinson-Brown, M.D.
Draion Burch, M.D.
Hugh Foka, M.D.
Robert Thompson, M.D.
Morris Turner, M.D.
OB Specialties
Edwin Cheek, M.D.
James Crozier, M.D.
Mark McCormick, M.D.
UPMC-Northwest
Magee Womens Specialties at Northwest
Eric Fackler, M.D.
L. Wayne Hess, M.D.
Bart Matson, D.O.
William McGrail, M.D.
John Myers, D.O.
Administration
Edward Sandy, II, MD, MBA
Dale Daley
Vice Chair, Community Practices
Executive Assistant
Jodi Buntain
Patty Genday
Wendy Kalocay
Department Administator
Administrator, Womancare Associates
Administrator, NIA and OB Specialties
Joyce Winkler
Administrator, Northwest, Horizon,
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Helen Fires
and Mercy Practices
Administrator, Passavant Practices
84
MAGEE-WOMENS RESEARCH INSTITUTE
OVERVIEW
Yoel Sadovsky, MD
MWRI Director
Magee-Womens Research Institute (MWRI) is home to University of Pittsburgh scientists
engaged in research in reproductive biology and women’s health. Unique to MWRI is the
multidimensionality of its reproductive biology research, spanning approaches from molecular
biology to epidemiology and community outreach, organisms from worms to humans, and
processes from early embryonic development to aging. MWRI's researchers use diverse basic,
translational, and clinical investigative tools that support our central mission to
 Advance knowledge in the field of reproductive biology and medicine
 Translate discoveries into improved health for women and their infants
 Train current and future scholars in the reproductive sciences
 Foster community investment and involvement in women’s health
MWRI houses all the research pursuits of the Department of Obstetrics, Gynecology and
Reproductive Sciences (OBGYN-RS), including basic, translational, clinical, behavioral, and
outcomes investigations, all taking place at MWRI’s research building on Craft Avenue, at
Magee-Womens Hospital, or at the Isaly building across the street from Magee-Womens
Hospital. The number of researchers at MWRI now includes 79 primary faculty members. Of
these, 64 are from the OBGYN-RS department. Among the 64 researchers, 40 are located in the
research building, where they are engaged primarily in basic and translational research, and 24
are located in Magee-Womens Hospital or in the Isaly building, where they are engaged
primarily in clinical and outcomes research. In addition to these, 37 University of Pittsburgh
researchers with primary appointments elsewhere at the university hold affiliate faculty
appointments at MWRI. These include representatives from the Departments of Microbiology
and Molecular Genetics, Cell Biology, Pharmacology and Chemical Biology, Medicine, Pediatrics,
and Psychiatry in the School of Medicine; Epidemiology, Human Genetics, Environmental and
Occupational Health, and Behavioral and Community Health Sciences in the Graduate School of
Public Health; Bioengineering in the Swanson School of Engineering; as well as representatives
of the Schools of Pharmacy and Nursing. MWRI's collaborative approach to research, affiliation
with the University of Pittsburgh and Magee-Womens Hospital of UPMC, and location
immediately adjacent to Magee’s large clinical patient care center further buttress our
individual research programs. We note that 52% of the Institute’s members are women.
Despite the recent reduction in NIH funding, MWRI continues to excel in securing financial
support for new and ongoing initiatives. As the research arm of the Department of OBGYN-RS,
MWRI remains a leader in NIH-funded research among obstetrics and gynecology departments
in the United States. In fiscal year 2012-2013, funding from all grants and contracts was $44.8
million, of which 88% ($39.4 million) was from Federal sources, primarily from the NIH, but
including entities such as the CDC and Department of Defense.
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Key new grants in the past academic year include:
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Renewal of our BIRCWH K12 grant for 2012-2017 (co-PIs: Sadovsky, Roberts)
A 3-year, $5 million grant from the Bill & Melinda Gates Foundation for a project,
entitled “HIV-Target Cell Response in Women Initiating Various Contraceptive Methods
in High HIV-incidence Areas” (Achilles)
A 5-year, $2.4 million (total) R01 grant from the National Institute of Child Health and
Human Development (NICHD), entitled “Primary Human Trophoblasts and the Transfer
of Viral Resistance” (co-PIs: Sadovsky, Coyne)
A 3-year, $450,000 (total) grant from the Ovarian Cancer Research Fund, entitled "Novel
Strategy of Metabolic Targeting Ovarian Cancer: Focusing on the Tumor Hypoxia
Pathway" (Huang)
A 5-year, $1.3 Million R01 grant from the National Institute of General Medical Sciences,
entitled "Characterization of the Meiotic Crossover Surveillance System" (Yanowitz)
A 2-year, $697,000 grant as a part of the National Children's Study, targeting stress and
cortisol measurements (Simhan)
A 1-year, $250,000 grant from the Pennsylvania Commission on Crime and Delinquency,
entitled "Men Embracing Nonviolence and Safety (MEN/S): An Ethnographic Study of
Batterers Intervention Programs" (Chang)
Reselection as a site for the NICHD Contraceptive Clinical Trials Network. The contract is
projected for 7 years, $350,000 total (Chen)
A 1-year, $25,000 grant from Pitt's CTSI-BaCCoR (Basic to Clinical Collaborative Research
Pilot Program), entitled "The Role of Placental Lymphatics in Preeclampsia and IUGR"
(co-PIs: Simhan, Baty)
A 1-year, $20,000 grant from the CTSI T2CP2 Program, entitled "Contribution of
Adipocyte Lipolysis to Adipocyte Function and Metabolic Phenotypes” (Menke)
Highlighted research accomplishments
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New endowed chairs:
o Aleksandar Rajkovic now holds the Marcus Allen Hogge Chair in Reproductive
Genetics, and Dr. Sharon Hillier now holds the Richard L. Sweet Chair of
Reproductive Infectious Diseases.
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Awards
o Kathy Ryan was awarded Pitt's Distinguished Service in Medical Education
Award in December. This is the highest honor in medical education given by the
University of Pittsburgh School of Medicine.
o Lisa Rohan received the 225th Anniversary Medallion from Chancellor Mark A.
Nordenberg. This award recognizes alumni who have built better lives for others
through their own life's work.
o Lisa Bodnar, an affiliate member of MWRI from the Department of Epidemiology
and a collaborator of many MWRI members, received the Chancellor's
Distinguished Research Award.
o Malgorzata Skaznik-Wikiel, a gynecologic oncology fellow in Kyle Orwig's lab,
won the Scientific Program Prize Paper Award at the recent American Society
for Reproductive Medicine for her work in using granulocyte colony stimulating
factor to protect ovarian follicles from the toxic effects of chemotherapy.

MWRI in the media (Samples)
o Yoel Sadovsky gave an interview to Reuters Health on July 20, 2012, about the
use of steroids for fetal lung immaturity.
o The University of Pittsburgh Cancer Institute (UPCI) magazine, Cancer Discovery
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o
o
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and Care, printed an extensive article about Kyle Orwig’s Fertility Preservation
Program. The work of Dr. Sanfilippo, Dr. Dovey, and many collaborators from
MWRI and Magee-Womens Hospital is featured in this review.
NBC Nightly News aired a story about Sylvia Bernassoli, who has worked at
Magee-Women’s Hospital for 55 years, most recently in the Center for Fertility
and Reproductive Endocrinology, and elected to donate her life savings to
promote fertility research at Magee and MWRI.
Pittsburgh’s NPR station, WESA, aired an interview with Drs. Sadovsky and
Coyne on July 2, 2013, regarding their recent publication in the Proceedings of
the National Academy of Sciences reporting the unique function of placental
microRNAs.
Lectures
o Drs. Sadovsky and Chaillet lectured on “Epigenetic Regulation of Fetal and
Placental Development” at the International Federation of Placenta
Associations’ Annual Human Placenta Workshop and Symposium, held at
Queen's University, Kingston, Ontario, Canada, in July 2012.
o Dr. Sadovsky presented "Biology of Preterm Birth, Knowledge Gaps, Need for
Discovery" at a joint meeting of the Bill and Melinda Gates Foundation, the
Global Alliance to Prevent Prematurity and Stillbirth, NICHD, and the March of
Dimes in Seattle, Washington.
o Dr. Hillier was invited by NIH Director, Francis Collins, to lecture on September
8, at the NIH Day Celebration of Science, on “HIV/AIDS: Today's Promise,
Tomorrow's Progress.”
o Dr. Sadovsky gave a talk at Kobe University, in Japan, entitled "How Does the
Placenta Get Fat?" on September 13, 2012.
o Drs. Orwig and Sadovsky participated in the Kansas University Medical Center's
Greenwald Symposium. Dr. Orwig talked about "Translating Spermatogonial
Stem Cell Transplantation to the Clinic; Dr. Sadovsky’s subject was "FetoPlacental Defense: A Macro Role for microRNAs."
o Dr. Yanowitz was invited to give two talks about her research, one at the
University of Virginia, entitled "Deciphering the Recombination
Landscape," and one at Princeton, entitled "X and the Art of Crossover
Maintenance."
o In August 2012, Dr. Plant gave a talk on "The Neurobiology of GnRH Pulsatility: A
Mode of Hypothalamic Activity Essential for Folliculogenesis, Ovulation, and
Spermatogenesis" at the Annual Meeting of the Society for the Study of
Reproduction at Pennsylvania State College. At the same meeting, Dr. Rajkovic
gave a talk on "Molecular Mechanisms and Consequences of Premature Ovarian
Aging."
o Dr. Rajkovic gave a talk on "Genomic Markers for Ovarian Failure" at the NICHD–
American Society for Reproductive Medicine conference on ovarian reserve.
o Dr. Yatsenko talked, in November, about UBE2B mutations and their association
with severe oligozoospermia at the 7th European Congress of Andrology, in
Berlin.
o Dr. Plant gave several talks in Argentina in October 2012: “Principles and History
of Neuroendocrinology,” and “Neurobiological Mechanisms for Puberty Onset in
Higher Primates” (both as part of the Argentinian Society for Neuroscience’s
Course for Young Investigators), “Kisspeptin: a GnRH Pulse-Generating or
Puberty-Initiating Neuropeptide,” and “Postnatal Development of the Testis in
the Monkey.”
o Dr. Sadovsky gave a talk about placental miRNAs at the University of Edinburgh,
in Scotland, in January 2013.
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o
Dr. Achilles talked about her research on oral contraceptives and HIV prevention
at the annual meeting of the American Society of Reproductive Immunology in
Boston and at a meeting in Miami on Long-Acting Hormonal Therapies for
Treatment and Prevention.
Research areas
Research programs at MWRI center on diverse aspects of reproductive biology and women’s
and infant’s health. These include the following main areas:
Reproductive development
Research in this general area centers on early embryonic development, gonadal and germ cell
development and differentiation, reproductive aging, and meiotic crossover recombination. Key
researchers include Yaacov Barak, Richard Chaillet, Kyle Orwig, Aleksandar Rajkovic, Gerald
Schatten, and Judith Yanowitz.
Overview
Research studies in this area encompass differentiation of human and nonhuman embryonic
stem cells into germ cells; mechanisms of germ cell formation and differentiation; adipogenesis;
and mechanisms of meiotic recombination and aneuploidy. Initiatives also include genetics;
epigenetics; imprinting; the molecular biology of gametes, embryos, and stem cells; the origins
of developmental diseases; and the potential of stem cells for treating human disease. The
studies utilize diverse animal models, including worms, mice, and nonhuman primates.
Translational efforts emanating from such studies touch upon better understanding of male and
female infertility; genetic determinants of reproductive aging; regeneration of gonadal and
reproductive tract tissues; and early embryonic development; origin of aneuploidy; and genomic
imbalances.
Discoveries, patents, and investigational new drug (IND) applications this past year included an
invention disclosure by Yaacov Barak, “Hybrid Mouse Embryonic Stem Cells”, filed on May 16th
and currently under review by the Office of Technology Management.
Selected publications
1. Simerly C, Schatten G. Utility of animal models for human embryo culture: nonhuman
primates. Methods Mol Biol 2012;912:39-59.
2. Easley CA 4th, Phillips BT, McGuire MM, Barringer JM, Valli H, Hermann BP, Simerly CR,
Rajkovic A, Miki T, Orwig KE, Schatten GP. Direct differentiation of human pluripotent
stem cells into haploid spermatogenic cells. Cell Rep 2012;2:440-6.
3. Hermann BP, Sukhwani M, Winkler F, Pascarella JN, Peters KA, Sheng Y, Valli H,
Rodriguez M, Ezzelarab M, Dargo G, Peterson K, Masterson K, Ramsey C, Ward T,
Lienesch M, Volk A, Cooper DK, Thomson AW, Kiss JE, Penedo MC, Schatten GP,
Mitalipov S, Orwig KE. Spermatogonial stem cell transplantation into rhesus testes
regenerates spermatogenesis producing functional sperm. Cell Stem Cell 2012;11:71526.
4. Shalom-Barak T, Zhang X, Chu T, Timothy Schaiff W, Reddy JK, Xu J, Sadovsky Y, Barak Y.
Placental PPARγ regulates spatiotemporally diverse genes and a unique metabolic
network. Dev Biol 2012;372:143-55.
5. Suzuki H, Dann CT, Rajkovic A. Generation of a germ cell-specific mouse transgenic
CHERRY reporter, Sohlh1-mCherryFlag. Genesis 2013;51:50-8.
6. Schatten G. Cellular promiscuity: explaining cellular fidelity in vivo against unrestrained
pluripotency in vitro. EMBO Rep 2013;14:4.
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7. Balakrishnan A, Chaillet JR. Role of the inositol polyphosphate-4-phosphatase type II
Inpp4b in the generation of ovarian teratomas. Dev Biol 2013;373:118-29.
8. Shi Q, Schatten G, Hodara V, Simerly C, Vandeberg JL. Endothelial reconstitution by
CD34+ progenitors derived from baboon embryonic stem cells. J Cell Mol Med
2013;17:242-51.
Pregnancy and newborn medicine
Research in this general area centers on prenatal genetics, feto-placental development, preterm
birth, preeclampsia, and newborn medicine. Key researchers include Yaacov Barak, Steve Caritis,
Janet Catov, Richard Chaillet, Tianjiao Chu, Jennifer Condon-Jeyasuria, Kata Himes, Robin
Gandley, Carl Hubel, Jacob Larkin, David Peters, Robert Powers, James Roberts, Yoel Sadovsky,
Hyagriv Simhan, and Jon Watchko.
Overview
Research in the areas of embryogenesis, pregnancy, and pregnancy outcomes centers on normal
and abnormal processes that shape fetal health. Investigators analyze diverse influences on the
feto-placental genome and epigenome and on gene expression, including gene imprinting, geneenvironment interactions, nutrition, and the effect of drugs and medications. The research also
includes uterine function and its implications for parturition. Prenatal influences are
interrogated through cutting-edge genetic tools, complemented by modern imaging
technologies. Building on these fundamental research trajectories, MWRI scientists collaborate
with other scientists at the University of Pittsburgh and worldwide to study key pregnancy
complications, such as preeclampsia, fetal growth restriction, and preterm birth, and the
neonatal and lifelong complications stemming from these diseases. Major initiatives include (a)
the use of next-generation sequencing of first trimester maternal plasma DNA to provide
improved diagnostic sensitivity and specificity over existing combinations of serum screening
and ultrasound; (b) preterm birth, including the understanding of the mechanisms by which
uterine quiescence is maintained throughout pregnancy and lost at term and the long-term risk
for cardiovascular disease of women who have had preterm birth; (c) cellular and molecular
mechanisms of preeclampsia, as well as behavioral, epidemiological, and clinical components
leading to the disorder, with emphasis on the mechanisms by which obese and overweight
women are at increased risk of developing preeclampsia; (d) molecular mechanisms, including
genomic and microRNA pathways, underlying early and late placental development,
differentiation, and adaptation to cellular injury and the metabolic processes that are essential
for micronutrient supply to the developing embryo; and (e) nanovesicle (exosome)-based fetalplacental-maternal interaction to maintain homeostasis and deliver microRNAs that attenuate
susceptibility to viral pathogens. Support by the Bill and Melinda Gates Foundation allows James
Roberts to facilitate a worldwide collaboration that spans 22 centers with data and biological
samples from 300,000 pregnant women, and relevant to adverse pregnancy outcomes.
Discoveries, patents, and IND applications this past year included a pending patent by Yoel
Sadovsky and Carolyn Coyne on the use of the chromosome 19 miRNA cluster (C19MC) for
treating microbial disease and promoting autophagy.
1. Grundmann M, Haidar M, Placzko S, Niendorf R, Darashchonak N, Hubel CA, von VersenHöynck F. Vitamin D improves the angiogenic properties of endothelial progenitor cells.
Am J Physiol Cell Physiol 2012;303:C954-62.
2. Caritis SN, Sharma S, Venkataramanan R, Hankins GD, Miodovnik M, Hebert MF, Umans
JG, Benedetti T, Mattison D, Zajicek A, Fischer D, Jackson A; Eunice Kennedy Shriver
National Institute of Child Health and Human Development Obstetrical-Fetal
Pharmacology Research Units Network. Pharmacology and placental transport of 1789
3.
4.
5.
6.
7.
8.
9.
hydroxyprogesterone caproate in singleton gestation. Am J Obstet Gynecol
2012;207:398.e1-8.
Weissgerber TL, Gandley RE, McGee PL, Spong CY, Myatt L, Leveno KJ, Thorp JM Jr,
Mercer BM, Peaceman AM, Ramin SM, Carpenter MW, Samuels P, Sciscione A, Harper
M, Tolosa JE, Saade G, Sorokin Y; Eunice Kennedy Shriver National Institute of Child
Health and Human Development Maternal-Fetal Medicine Units Network. Haptoglobin
phenotype, preeclampsia risk and the efficacy of vitamin C and e supplementation to
prevent preeclampsia in a racially diverse population. PLoS One 2013;8:e60479.
Gernand AD, Simhan HN, Klebanoff MA, Bodnar LM. Maternal Serum 25-Hydroxyvitamin
D and Measures of Newborn and Placental Weight in a U.S. Multicenter Cohort Study. J
Clin Endocrinol Metab 2013;98:398-404.
Himes KP, Koppes E, Chaillet JR. Generalized disruption of inherited genomic imprints
leads to wide-ranging placental def0ects and dysregulated fetal growth. Dev Biol
2013;373:72-82.
Catov JM, Lewis CE, Lee M, Wellons MF, Gunderson EP. Preterm Birth and Future
Maternal Blood Pressure, Inflammation, and Intimal-medial Thickness: The CARDIA
Study. Hypertension 2013;61:641-6.
Delorme-Axford E, Donker RB, Mouillet JF, Chu T, Bayer A, Ouyang Y, Wang T, Stolz DB,
Sarkar SN, Morelli AE, Sadovsky Y, Coyne CB. Human placental trophoblasts confer viral
resistance to recipient cells. Proc Natl Acad Sci USA 2013;110:12048-53.
Mouillet JF, Donker RB, Mishima T, Cronqvist T, Chu T, Sadovsky Y. Biol Reprod. The
Unique Expression and Function of miR-424 in Human Placental Trophoblasts
2013;89:25.
Gernand AD, Bodnar LM, Klebanoff MA, Parks WT, Simhan HN. Maternal serum 25hydroxyvitamin D and placental vascular pathology in a multicenter US cohort. Am J Clin
Nutr 2013;98:393-8.
Infectious diseases
Research in this general area centers on vaginal microbicides, sexually transmitted HIV
infections, reproductive tract infections, pharmaceutics, and drug delivery. Key researchers
include Sharon Achilles, Richard Beigi, Katherine Bunge, Charlene Dezzutti, Sharon Hillier, Ian
McGowan, Lisa Rohan, and Harold Wiesenfeld.
Overview
The study of reproductive infectious disease includes common infections, such as vaginitis, and
sexually transmitted diseases, such as HIV. This research includes infections that occur during
pregnancy, and those that affect adolescents, women of reproductive age, and postmenopausal
women. Current research ranges from basic studies into host-pathogen interactions, the impact
of sexually transmitted diseases and other lower genital tract infections on the development of
pelvic inflammatory disease, infertility, and identification of drug delivery systems designed to
protect women or men from acquisition of sexually transmitted infections. A unique focus is the
development of topical microbicides to prevent HIV in women and men. Major initiatives
include the Microbicide Trials Network (MTN), an HIV/AIDS clinical trials network, jointly
sponsored by NICHD and the National Institute of Allergy and Infectious Diseases, that brings
together international investigators and community and industry partners devoted to
preventing or reducing the sexual transmission of HIV through the development and evaluation
of products applied topically to mucosal surfaces or administered orally. In addition, the
pharmaceutics laboratory is dedicated to developing safe and effective products and identifying
essential criteria for drug delivery systems, with a focus on the design of drug delivery systems
targeted for prevention of HIV/AIDs.
Discoveries, patents, and IND applications this past year included a pending IND by Lisa Rohan
on Daprivirine film and combination HIV antiretroviral rectal microbicide (CHARM) gel, and a
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pending IND by Ian McGowan on tenofovir gel, an antiretroviral product for HIV prevention.
1. Dezzutti CS, Brown ER, Moncla B, Russo J, Cost M, Wang L, Uranker K, Kunjara Na
Ayudhya RP, Pryke K, Pickett J, Leblanc MA, Rohan LC. Is Wetter Better? An Evaluation
of Over-the-Counter Personal Lubricants for Safety and Anti-HIV-1 Activity. PloS One
2012;7:e48328.
2. Cosentino LA, Campbell T, Jett A, Macio I, Zamborsky T, Cranston RD, Hillier SL. Use of
nucleic acid amplification testing for diagnosis of anorectal sexually transmitted
infections. J Clin Microbiol 2012;50:2005-8.
3. Shavell VI, Moniz MH, Gonik B, Beigi RH. Influenza immunization in pregnancy:
overcoming patient and health care provider barriers. Am J Obstet Gynecol
2012;207:S67-74.
4. Anton PA, Cranston RD, Kashuba A, Hendrix C, Bumpus NN, Richardson-Harman N,
Elliott J, Janocko L, Khanukhova E, Dennis RA, Cumberland WG, Ju C, Carballo-Diéguez A,
Mauck C, McGowan IM. RMP-02/MTN-006: A Phase 1 Rectal Safety, Acceptability,
Pharmacokinetic and Pharmacodynamic Study of Tenofovir 1% Gel Compared to Oral
Tenofovir Disoproxil Fumerate. AIDS Res Hum Retroviruses 2012;28:1412-21.
5. Dezzutti CS, Richardson BA, Marrazzo JM, Tugetman J, Ramjee G, Taha T, Chirenje ZM,
Abdool Karim SS, Hillier SL, Herold BC; on behalf of the MTN Biomedical Sciences
Working Group and the HPTN 035 Protocol Team. Mucosal E. coli bactericidal activity
and immune mediators are associated with HIV-1 seroconversion in women
participating in the HPTN 035 trial. J Infect Dis 2012;206:1931-5.
6. McGowan I, Hoesley C, Cranston RD, Andrew P, Janocko L, Dai JY, Carballo-Dieguez A,
Ayudhya RK, Piper J, Hladik F, Mayer K. A Phase 1 Randomized, Double Blind, Placebo
Controlled Rectal Safety and Acceptability Study of Tenofovir 1% Gel (MTN-007). PloS
One 2013;8:e60147.
7. Moniz MH, Hasley S, Meyn LA, Beigi RH. Improving influenza vaccination rates in
pregnancy through text messaging: a randomized controlled trial. Obstet Gynecol
2013;121:734-40.
8. Wiesenfeld HC. Much is still unknown about cervicitis of unknown etiology. Sex Transm
Dis 2013;40:386-7.
9. Stoner KA, Rabe LK, Meyn LA, Hillier SL. Survival of Trichomonas vaginalis in wet
preparation and on wet mount. Sex Transm Infect,Epub ahead of print, April 2013.
10. Zhou T, Hu M, Cost M, Poloyac S, Rohan LC. Expression of Transporters and Metabolizing
Enzymes in the Female Lower Genital Tract: Implications on Microbicide Research. AIDS
Res Hum Retroviruses 2013, Epub ahead of print, May 2013.
Gynecology
Research in this area centers on family planning, benign gynecological disorders, urogynecology,
and pelvic floor dysfunction. Key researchers include Steve Abramowitch, Beatrice Chen, Chiara
Ghetti, Richard Guido, Jerry Lowder, Pamela Moalli, Gary Sutkin, and Halina Zyczynski.
Overview
Gynecology research focuses on women’s health from earliest reproductive age through
maturity. MWRI is one of the few research institutes in the country with a dedicated research
center for family planning and the development of new contraceptive methods. Research is also
intended to impact the use and availability of contraceptives in developing countries. Pelvic
floor disorders are a key area of basic, translational, and clinical research and include the
identification of mechanisms that lead to pelvic floor health and dysfunction, the testing of
synthetic meshes used for pelvic color surgery, and the assessment of means to prevent pelvic
floor injury. These studies target molecular, cellular, immunological, and biomechanical
approaches toward the decipherment of mechanisms of pelvic floor disorders. Studies are also
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designed to shed light on treatment and quality of life among women who suffer from pelvic
floor disorders and the long-term outcomes of commonly used interventions to correct urge and
stress urinary incontinence. New initiatives target mechanisms underlying the development of
fibroids and surgical techniques for the treatment of fibroids using radiofrequency ablation.
1. Zyczynski HM, Rickey L, Dyer KY, Wilson T, Stoddard AM, Gormley EA, Hsu Y, Kusek JW,
Brubaker L; for the Urinary Incontinence Treatment Network. Sexual activity and
function in women more than 2 years after midurethral sling placement. Am J Obstet
Gynecol 2012;207:421e1-6.
2. Visco AG, Brubaker L, Richter HE, Nygaard I, Paraiso MF, Menefee SA, Schaffer J, Lowder
J, Khandwala S, Sirls L, Spino C, Nolen TL, Wallace D, Meikle SF; Pelvic Floor Disorders
Network. Anticholinergic therapy vs. onabotulinumtoxina for urgency urinary
incontinence. N Engl J Med 2012;367:1803-13.
3. Skoczylas LC, Shepherd JP, Smith KJ, Lowder JL. Managing mesh exposure following
vaginal prolapse repair: a decision analysis comparing conservative versus surgical
treatment. Int Urogynecol J 2013;24:119-25.
4. Feola A, Abramowitch S, Jallah Z, Stein S, Barone W, Palcsey S, Moalli P. Deterioration in
biomechanical properties of the vagina following implantation of a high-stiffness
prolapse mesh. BJOG 2013;120:224-32.
5. Liang R, Abramowitch S, Knight K, Palcsey S, Nolfi A, Feola A, Stein S, Moalli PA. Vaginal
degeneration following implantation of synthetic mesh with increased stiffness. BJOG
2013;120:233-43.
6. Oliphant SS, Lowder JL, Ghetti C, Zyczynski HM. Effect of a preoperative selfcatheterization video on anxiety: a randomized controlled trial. Int Urogynecol J
2013;24:419-24.
7. Alperin M, Ellison R, Meyn L, Frankman E, Zyczynski HM. Two-year outcomes after
vaginal prolapse reconstruction with mesh pelvic floor repair system. Female Pelvic Med
Reconstr Surg 2013;19:72-8.
8. Skoczylas LC, Jallah Z, Sugino Y, Stein SE, Feola A, Yoshimura N, Moalli P. Regional
Differences in Rat Vaginal Smooth Muscle Contractility and Morphology. Reprod Sci
2013 20:382-90.
9. Turner LC, Shepherd JP, Wang L, Bunker CH, Lowder J. Hysterectomy surgery trends: a
more accurate depiction of the last decade? Am J Obstet Gynecol 2013;208:277.e1-7.
10. Nygaard I, Brubaker L, Zyczynski HM, Cundiff G, Richter H, Gantz M, Fine P, Menefee S,
Ridgeway B, Visco A, Warren LK, Zhang M, Meikle S. Long-term outcomes following
abdominal sacrocolpopexy for pelvic organ prolapse. JAMA 2013;309:2016-24.
Reproductive endocrinology and fertility
Research in this general area centers on the hypothalamic-pituitary-gonadal axis, gonadal
biology, female and male germ cell development, infertility, and fertility preservation. Key
researchers include Kyle Orwig, Tony Plant, Aleksandar Rajkovic, Abhiram Sahu, William Walker,
Alexander Yatsenko, and Anthony Zeleznik.
Overview
MWRI researchers from this group interrogate the fundamental mechanisms that govern germ
cell development and reproduction in mammalian species. Research ranges from the
biochemical to the genetic and from in vitro cell biology to in vivo systems biology that spans
mammalian evolution from rodents, through nonhuman primates, to humans. Studies include
the endocrine regulation of the hypothalamic-pituitary-gonadal axis that affects ovulation,
fertilization, and implantation, the menstrual cycle and menopause, and the cross-talk between
the brain and gonads that regulates the transition from infancy, through puberty, to adulthood.
Investigation also centers on the developmental and molecular mechanisms that establish the
92
female and male germ lineages during fetal development and give rise to oogenesis and
spermatogenesis in postnatal mammals. This includes a focus on spermatogonial stem cells in
order to gain insight into how these cells maintain male fertility and how they might be
exploited to regenerate spermatogenesis in cases of male infertility. Researchers from this
group are actively investigating the genetics of infertility and use high-throughput genetic
screens of patient tissues designed to identify genetic lesions associated with infertile
phenotypes. Current studies are designed to characterize the effects of cancer treatments on
the germ cell and somatic/endocrine environments of ovaries and testes and to develop means
to protect or restore fertility. These investigators also serve as the core of the Fertility
Preservation Program, a collaborative effort that provides new options for preserving fertility in
boys who may lose fertility because of cancer treatment or other diseases.
Discoveries, patents, and IND applications this past year included a patent application filed by
William Walker, entitled “Animal Sterilization Using Inhibitors of the SHP2 Tyrosine
Phosphatase.”
1. Yatsenko AN. ETV5 mutations: revisiting Sertoli cell only syndrome. Fertil Steril
2012;98:821.
2. Gassei K, Orwig KE. SALL4 Expression in gonocytes and spermatogonial clones of
postnatal mouse testes. PLoS One 2013;8:e53976.
3. Terasawa E, Guerriero KA, Plant TM. Kisspeptin and puberty in mammals. Adv Exp Med
Biol 2013;784:253-73.
4. Sahu A, Koshinaka K, Sahu M. PI3K is an upstream regulator of the PDE3B pathway of
leptin signaling that may not involve activation of Akt in the rat hypothalamus. J
Neuroendocrinol 2012;25:168-79.
5. Puri P, Walker WH. The tyrosine phosphatase SHP2 regulates Sertoli cell junction
complexes. Biol Reprod. 2013;88:59.
6. Dovey SL, Valli H, Hermann BP, Sukhwani M, Donohue J, Castro CA, Chu T, Sanfilippo JS,
Orwig KE. Eliminating malignant contamination from therapeutic human spermatogonial
stem cells. J Clin Invest 2013;123:1833-43.
7. Ramaswamy S, Dwarki K, Ali B, Gibbs RB, Plant TM. The decline in pulsatile GnRH
release, as reflected by circulating LH concentrations, during the infant-juvenile
transition in the agonadal male rhesus monkey (Macaca mulatta) is associated with a
reduction in kisspeptin content of KNDy neurons of the arcuate nucleus in the
hypothalamus. Endocrinology 2013 Mar 22. [Epub ahead of print]
8. Skaznik-Wikiel ME, McGuire MM, Sukhwani M, Donohue J, Chu T, Krivak TC, Rajkovic A,
Orwig KE. Granulocyte colony-stimulating factor with or without stem cell factor
extends time to premature ovarian insufficiency in female mice treated with alkylating
chemotherapy. Fertil Steril 2013;99:2045-54.
Women’s cancer
Research in this general area, under the umbrella of the Women’s Cancer Research Center (a
joint initiative of UPCI and MWRI, housed at MWRI’s research building), includes reproductive
tract cancers and breast cancer. Key researchers include Robert Edwards, Melanie Flint, Xin
Huang, Joseph Kelley, Faina Linkov, Adrian Lee, Priscilla McAuliffe, Francesmary Modugno,
Carola Neumann, Steffi Oesterreich, and Anda Vlad.
Overview
MWRI’s cancer biology team of basic, translational, and clinical researchers investigate the
fundamental processes that lead to carcinogenesis in the breast and female pelvic organs. The
group includes fundamental research labs and gynecologic oncology academicians whose
93
collaborative work focuses on the identification of biomarkers for pre-invasive or early-stage
disease as predictors of severity, prognosis, and response to therapy. The group seeks to
advance our understanding of disease pathogenesis in breast and gynecologic malignancies and
to improve disease treatments through novel combinational therapies. The Women’s Cancer
Research Center is designed to foster new research collaboration, education, and enhancement
of community awareness. Major initiatives include the development of transgenic mouse
models to study the pathogenesis of ovarian cancer; the unique role of steroid hormones and
growth factors in the initiation and progression of breast cancer; and miRNA pathways that
contribute to cancer, particularly in the context of tumor hypoxia. A multicenter study, with
investigators from Roswell Park Cancer Institute, Dana Farber Cancer Center, Memorial SloanKettering Cancer Center, and others, was recently initiated to investigate factors associated with
molecular signatures in female cancers.
Discoveries, patents, and IND applications this past year included a patent application filed by
Xin Huang and Anda Vlad, entitled “Plasma microRNAs as Biomarkers for Endometriosis and
Endometriosis-Associated Ovarian Cancer.”
1. Beriwal S, Kannan N, Sukumvanich P, Richard SD, Kelley JL, Edwards RP, Olawaiye A,
Krivak TC. Complete metabolic response after definitive radiation therapy for cervical
cancer: Patterns and factors predicting for recurrence. Gynecol Oncol 2012;127:303-6.
2. Budiu RA, Elishaev E, Brozick J, Lee M, Edwards RP, Kalinski P, Vlad AM. Immunobiology
of human mucin 1 in a preclinical ovarian tumor model. Oncogene 2013;32:3664-3675.
3. Suryawanshi SM, Vlad AM, Lin HM, Smaldone GM, Laskey R, Lee M, Lin Y, Donnellan N,
Klein-Patel M, Lee T, Mansuria S, Elishaev E, Budiu R, Edwards RP, Huang X. Plasma
microRNAs as novel biomarkers for endometriosis and endometriosis-associated ovarian
cancer. Clin Cancer Res 2013 19:1213-24.
4. Lesnock JL, Darcy KM, Tian C, Deloia JA, Thrall MM, Zahn C, Armstrong DK, Birrer MJ,
Krivak TC. BRCA1 expression and improved survival in ovarian cancer patients treated
with intraperitoneal cisplatin and paclitaxel: a Gynecologic Oncology Group Study. Br J
Cancer. 2013;108:1231-7.
5. Sikora MJ, Jankowitz RC, Dabbs DJ, Oesterreich S. Invasive lobular carcinoma of the
breast: Patient response to systemic endocrine therapy and hormone response in model
systems. Steroids 2013;78:568-75.
6. Oesterreich S, Edwards R, Vlad A. Progestins: Pro-senescence therapy for ovarian
cancer? Cell Cycle 2013;12:1662-3.
7. Hinshaw HD, Smith A, Rungruang B, Kelley JL Jr, Beriwal S, Krivak TC, Sukumvanich P,
Olawaiye AB. The Risk of Subsequent Malignancies in Women With Uterine Papillary
Serous or Clear Cell Endometrial Cancers. Int J Gynecol Cancer 2013;1044-9.
Publications also include large collaborative studies in which our researchers contributed.
1. Permuth-Wey J, et al. Identification and molecular characterization of a new ovarian
cancer susceptibility locus at 17q21.31. Nat Commun 2013;4:1627.
2. Shen H, et al. Epigenetic analysis leads to identification of HNF1B as a subtype-specific
susceptibility gene for ovarian cancer. Nat Commun 2013;4:1628.
3. Pharaoh PD, et al. GWAS meta-analysis and replication identifies three new
susceptibility loci for ovarian cancer. Nat Genet 2013;45:362-70, 370e1-2.
4. Bojesen SE, et al. Multiple independent variants at the TERT locus are associated with
telomere length and risks of breast and ovarian cancer. Nat Genet 2013;45:371-84,
384e1-2.
5. Cancer Genome Atlas research Network, et al. Integrated genomic characterization of
endometrial carcinoma. Nature 2013;497:67-73.
94
Women’s health and wellness
Research in this general area centers on health services outcomes, patient-provider
communication, behavioral health and alternative medicine, quality of life measures, medical
decision making, and community-based research. Key researchers include Aletha Akers, Judy
Chang, and Elizabeth Krans.
Overview
MWRI investigators perform health services and behavioral health research in women's health.
Health services research uses multidisciplinary approaches to examine the interaction of health
care services and the populations and individuals affected by these services. This includes drug
abuse by pregnant women and choices made during pregnancy and behavioral research that
addresses the best practices for improving the quality and cost-effectiveness of women's care
and health services delivery. Ongoing projects include studies of intimate-partner violence,
substance use, and patient-provider communication. The latter studies are designed to facilitate
understanding of the communication approaches, elements, and styles that contribute to better
patient health understanding, positive behavior change, informed medical decision making, and
improved outcomes. Adolescent sexual decision making, parent-child communication about
sexual health education, and sexual health issues are also pursued, as is the relationship
between body weight and sexual risk behaviors.
1. Krans EE, Chang JC. Low-income African American women's beliefs regarding exercise
during pregnancy. Matern Child Health J 2012;16:1180-7.
2. Akers AY, Gold MA, Coyne-Beasley T, Corbie-Smith G. A qualitative study of rural black
adolescents' perspectives on primary STD prevention strategies. Perspect Sex Reprod
Health 2012;44:92-9.
3. Lloyd SW, Ferguson YO, Corbie-Smith G, Ellison A, Blumenthal C, Council BJ, Youmans S,
Muhammad MR, Wynn M, Adimora A, Akers A. The role of public schools in HIV
prevention: perspectives from African Americans in the rural South. AIDS Educ Prev
2012;24:41-53.
4. Chang JC, Alexander SC, Holland CL, Arnold RM, Landsittel D, Tulsky JA, Pollak KI. Am J
Health Promot. Smoking is bad for babies: obstetric care providers' use of best practice
smoking cessation counseling techniques. 2013;27:170-6.
5. Krans EE, Davis MM, Schwarz EB. Psychosocial Risk, Prenatal Counseling and Maternal
Behavior: Findings from PRAMS, 2004-2008. Am J Obstet Gynecol 2013;208:141.e1-7.
Education
The field of reproductive biology is in need of bright, creative, and energetic new scholars who
can advance knowledge in the areas of reproductive development, reproductive physiology, and
reproductive diseases. These scholars can capitalize on genomics and informatics technologies
to illuminate unsolved questions in basic, translational, and clinical women’s health sciences. As
one of the largest academic institutions in our field, we seek to capture the imagination of
young scholars and train the next generation of researchers in the area of reproductive sciences
and women’s health. This year we have bolstered our training programs at all levels of academic
development, as detailed below.
Faculty training
At the faculty level, we have two NIH (K12)-funded programs which center on early faculty
career development. The first program, Building Interdisciplinary Research Careers in Women’s
Health (BIRCWH), is a University of Pittsburgh program that supports the development of young
faculty members as independent investigators in translational, clinical, epidemiologic, or health
services research along women’s lifespan. The program is designed for faculty with
95
appointments within the University of Pittsburgh’s six schools of the health sciences, whether
MDs or PhDs, and has been a tremendous success. This program was renewed this academic
year by the NIH for another 5 years, and recently appointed trainees include Drs. Bryan Brown,
Francesca Facco, and Haitao Yang. The second program, the Women's Reproductive Health
Research (WRHR) program, is designed to prepare outstanding OBGYN junior MD faculty for a
productive and exciting investigative career in reproductive biology and biomedical research,
emphasizing basic or translational research that is directly relevant to reproductive biology. This
program currently includes three trainees, Drs. Katherine Himes, Jacob Larkin, and Marie
Menke. Another trainees at MWRI benefited from our Magee Auxiliary Research Scholar (MARS)
endowment (Dr. Yanowitz). Additional faculty have embarked on new training or early
investigators programs this year: Dr. Yanowitz, who received a Basil O'Connor Starter Scholar
Research Award from the March of Dimes, and Dr. Krans, who received a KL2 Award through the
University of Pittsburgh CTSI.
Postdoctoral training
MWRI hosts two programs for postdoctoral training. The MWRI Postdoctoral Fellowship
Program prepares individuals for independent and productive careers as research scientists by
providing them with the environment necessary for an intensive research experience. Both MD
and PhD trainees participate in highly focused research projects that impact a number of
problems related to reproductive biology, reproductive development, and women’s and infants’
health. We typically have 2-4 trainees, each for 1 to 2 years of training. In addition, this year, Dr.
Caritis and Dr. Venkataramanan launched a new NIH T32 postdoctoral training program in basic
and clinical pharmacology in pregnancy. In addition to these programs, postdoctoral fellows
have been successful in partnering with their mentors to receive funding for their training. One
example is a 1-year, $10,000 grant from the Morris Animal Foundation, entitled "Chemical
Ablation of SHP2 Activity by NSC-87877 To Develop a Sterilant for Cats and Dogs" (Dr. Puri).
Resident and clinical fellows training
Our Clinical Trainee Research Award provides financial support for the research activities of
residents and clinical fellows based at Magee-Womens Hospital. It promotes research education
by training them to prepare and write grant applications that include a hypothesis, a study
design (including sample size), a budget, and a method for protecting research subjects.
Typically, three residents or clinical fellows are supported every year.
Graduate training
MWRI graduate students have a unique opportunity to take part in the process of translating
fundamental laboratory bench discoveries in the field of reproductive sciences to the bedside.
Over the past year, additional MWRI researchers have become members of several graduate
programs within the University of Pittsburgh. MWRI graduate faculty, led by Judy Yanowitz and
Jennifer Condon, developed a new reproductive biology course for the interdisciplinary
biomedical graduate program, which was deployed in the fall of 2011. We note that Judith
Yanowitz was selected to be a mentor for a student in a new program called "CHOOSE
Development", a project funded by the National Science Foundation and administered by the
Society for Developmental Biology that includes a stipend for two summers for the student¹s
full-time research internship in Dr. Yanowitz's research group. We also highlight that Dr. Steve
Abramowitch, a Bioengineering member of MWRI and a BIRCWH trainee, was selected as the
recipient of the 2011-2012 Swanson School of Engineering Diversity Award for his exceptional
work in leading a summer program involving middle school and high school student summer
camps in Pittsburgh and Greensboro, NC, and for his excellent mentorship of outstanding
undergraduate and underrepresented students.
College and High-school Summer Internship Program
The College Student Summer Internship Program provides students with the opportunity to
96
participate in basic, translational or clinical scientific research, with the goal of stimulating
students to engage in reproductive sciences research. This highly successful 8-week program
continues to attract students from western Pennsylvania and beyond. Similarly, our 4-week high
school program provides current high school juniors and seniors with early education in science
related to women’s and infants’ health. In addition to research, trainees in the two programs
enjoy informal lunch meetings, at which investigators discuss biomedical science as a career.
MWRI’s national training programs
Sponsored through two R25 grants from the NIH’s National Cancer Institute and National
Institue for Aging, MWRI’s Dr. Schatten has engaged in a national program designed to train
promising physician-scientists and other scientists from predominately underrepresented
communities in sophisticated technologies using pluripotent stem cells for clinically relevant
discoveries in aging and cancer. The program includes advanced dynamic training courses that
provide a fresh series of daily lecturers on emerging concepts, followed by extended discussion,
laboratory research, technologically intense workshops, and informal seminars over week-long
periods. National and international education initiatives by Dr. Schatten and his team are
bolstered, this year, by T15 and U13 conference grants.
MWRI Research Day in Reproductive Biology and Women’s Health
The Annual Research Day was instituted to provide our trainees with the opportunity to present
their research to faculty and staff from the Institute, Hospital, and University of Pittsburgh and
to raise the level of awareness within the broader academic community about our programs in
women’s and infants’ health research. On May 31, 2012, we were honored to host Dr. Jerome
Strauss, Dean of the Virginia Commonwealth School of Medicine, who gave the Margaret Prine
Joy Lecture in Reproductive Sciences and the Celebration of Life: A Lecture Honoring Mothers.
Each lecture covered a unique topic, with the first reporting on Dr. Strauss’ research on
polycystic ovary syndrome and the second addressing medicine and biomedical research in the
information age. The program included oral presentations by invited speakers and selected
faculty investigators and fellows, graduate students, and residents, as well as a trainees’ poster
session.
Final note
MWRI’s research themes provide a unique platform where fundamental questions relevant to
reproductive biology and women’s health are pursued using basic, translational, and clinical
research tools. We strive to develop robust investigative programs that will further our
understanding of diseases that affect women and their newborns and train the next generation
of scholars in our rapidly developing field. For more information, please review our website at:
http://www.mwrif.org.
97
RESEARCH GRANTS AND CONTRACTS
PI
Grant Title
Funding
Type
FY13
Direct
Indirect
ACHILLES
Quantification of Immune Cells
in Women Using Contraception
Federal
372,129
133,901
ACHILLES
HIV - TCR in Women Initiating
Contraceptive Methods
Foundation
3,078,140
461,720
AKERS
Media Intervention for African
American Parents
Foundation
46,921
5,579
AKERS
Relationships Between
Adolescent Weight, Sexual
Behavior and Reproductive
Outcome
Modulation of Hormonal System
Immunity by Hormonal
Contraceptive
University of Pittsburgh Clinical
And Translational Science Grant
(CRC)
Novel Mechanisms of PPARg in
Adipose Tissue Development
Federal
145,583
6,779
Federal
1,693
999
Federal
31,751
16,352
Federal
257,087
81,949
BEIGI
University of Pittsburgh Clinical
Trials Unit
Federal
19,275
11,340
BEIGI
2009 H1N1 Influenza in
Pregnancy
Federal
23,123
11,909
BEIGI
39th Annual Scientific Meeting
of the Infectious Diseases
Society
Fellowship in Family Planning &
Contraception
Federal
3,000
0
Foundation
84,895
0
CARITIS
Multi Center Network of
Maternal Fetal Medicine
Federal
47,995
19,624
CARITIS
OPRU (Initial Award and
Competitive Renewal)
Federal
619,279
235,051
CARITIS
Training in Basic and Clinical
Pharmacology in Pregnancy
Federal
122,732
9,099
CARITIS
Pharmacokinetic And
Bioavailability of Granisetron
Transdermal System (Sancuso)
in Pregnancy
Industry
104,050
26,013
AKERS
BALK
BARAK
BORAAS
98
CATOV
Preterm Delivery and Maternal
Cardiovascular Disease Risk
Federal
292,326
52,103
CATOV
Tobacco Funds 2013
State
115,874
23,175
CHANG
Communication on Illicit Drug
and/or Alcohol Use in Obstetrics
Federal
348,834
68,297
CHANG
Prevalence, Trends, and
Correlates of Waterpipe
Tobacco Smoking among U.S.
University Students
Communication on Illicit Drug
and/or Alcohol Use in
Obstetrics- Supplement
Men Embracing Nonviolence
and Safety (MEN/S)
Federal
4,500
2,318
Federal
22,546
10,824
Federal
89,277
10,713
Efficacy and Safety of the
Transdermal Contraceptive
Patch
Effect of Timing of Postpartum
depot Medroxyprogesterone
Acetate, Administration on
Breastfeeding
University of Pitts Clinical Trials
Unit- MTN013
Industry
12,000
3,000
Foundation
25,000
5,000
Federal
108,841
64,217
CHEN
Contraception
Foundation
54,591
0
CHEN
SFP Study - Cervical Prep before
Dilation and Evacuation
Foundation
34,614
5,192
CHEN
Core Function Activities
Federal
41,117
17,214
CHEN
Development of Levenorgestrel
IUD for US Public Sector
Industry
60,417
12,084
CHEN
Multicenter open label Ramdom
study of Amphora to Conceptrol
Industry
58,812
14,547
CHEN
Clinical Evaluation of
Nestorone/Estradiol-Releasing
Vaginal Ring
Core Function Activities Task
Order
Federal
96,758
28,772
Federal
22,099
5,288
Clinical Evaluation of
Levonorgestrel Butanoate for
Contraception
Tobacco Funds 2013
Federal
116,667
28,054
State
281,952
56,390
CHANG
CHANG
CHEN
CHEN
CHEN
CHEN
CHEN
CHU
99
CONDON
Caspase -3 Maintains Uterine
Quiescence in PR in a NF -Kappa
B Dependent Manner
Uterine Quiescence During
Pregnancy is Maintained
Federal
194,121
95,043
Foundation
138,764
13,877
CREMER
Basic Health International
Research
Industry
131,865
0
CREMER
FP Knowledge, Attitudes and
Practices among Bhutanese
Women
Long Acting Acceptable
Microbicides:Novel Delivery,
Activity
Highly Innovative Tactics to
Interrupt Transmission of HIV
(HIT-IT)
Cervical Explants/Ex-Vivo Assays
under "Comprehensive
Resources for HIV Microbisiedes
and Biomedical Intervention
Development and Evaluation of
Dual Compartment Combination
Foundation
3,750
0
Federal
38,727
22,655
Federal
61,048
34,535
Federal
40,062
23,637
Federal
70,761
49,713
Development of a Novel
Nanoparticle Pyrimidinedione
Vaginal
Assessing the safety,
pharmacokinetics,
pharmacodynamics, and
disintegration time of vaginal
tablets containing tenofovir and
/or emtricitabine
Ovarian Cancer. Prevention of
Disease and its Occurrence
Federal
46,347
27,113
Federal
14,265
2,140
Federal
5,000
0
EDWARDS
Bariatric Surgery Implications
for Endrometrical Cancer Risk
Foundation
2,711
206
EDWARDS/KRIVAK
Gynecological Cancer
Translational Research CoE
Federal
15,753
9,295
EDWARDS/ZORN
Phase II study of RAD001 &
Bevacizumab in Recurrent
Ovarian cancer peritoneal and
Fallopian Tube Cancer
Mechanisms and Prevention of
Etoposide-Induced Leukemia
Industry
57,941
2,580
Federal
1,125
658
Minerva Pivotal Study
Industry
169,200
42,300
CONDON
DEZZUTTI
DEZZUTTI
DEZZUTTI
DEZZUTTI
DEZZUTTI
DEZZUTTI
EDWARDS
GANDLEY
GUIDO
100
HILLIER
Microbicides Trial Network
Federal
9,569,370
4,746,619
HILLIER
Safety Model for Topical
Microbicides Post-coital Safety
Federal
4,132
2,409
HILLIER
Topical Microbicide Safety &
Efficacy Eval. in Primates
Federal
47,631
27,232
HILLIER
Sexually Transmitted Infection
Cooperative Res Center Proj 2
Federal
192,055
108,825
HILLIER
Alternative Formulations of
Tenofivir and UC781
Federal
2,263,528
484,390
HILLIER
Protocol AMP001
Industry
15,000
3,750
HILLIER
Advances in Health Sevices
Agreement
Industry
150
23
HILLIER
Immunological Factors and Risk
of Vulvodynia
Federal
36,589
17,179
HILLIER
Metrogel 1.3% Bacterial
Vaginosis project
Industry
13,500
3,375
HILLIER
Alfa Wasserman Services
Agreement
Industry
97,307
24,327
HILLIER
TFV IVR Study Microflora Testing
Federal
3,800
2,242
HILLIER
Cancer Center Support Grant
Federal
3,300
1,947
HILLIER
A Multicenter, Prospective,
Randomized, Controlled CrossOver Study to Assess Changes in
Vaginal Microfora While Using
the TIPI Vainal Pessary in the
Temporary Management of
Stress Urinary Incontinence SUI
in females
Assessing the safety,
pharmacokinetics,
pharmacodynamics, and
disintegration time of vaginal
tablets containing tenofovir and
/or emtricitabine
Test for the presence of
bacteria/microorganisms
Industry
4,598
1,149
Federal
13,200
1,980
Federal
6,500
3,835
Sickle Cell
Federal
16,786
4,029
HILLIER
HILLIER
HOGGE
101
HUANG
The Mechanism of miR-210
Regulating Cellular Metabolism
Foundation
155,333
24,667
HUANG
Novel Strategy of Metabolic
Targeting Ovarian Cancer
Foundation
144,128
5,872
HUBEL
Mechanisms of Preeclampsia
Federal
917,991
324,397
HUBEL
Tobacco funds 2013
State
97,912
19,582
LARKIN
AAOGF/SMFM Scholarship
Foundation
100,000
0
LARKIN
Tobacco funds 2013
State
70,655
14,131
LIANG
Effects of
Bazefoxifen/Conjugated
estrogens complex
Bariatric Surgery: Implications
for Endometrial Cancer
Industry
18,462
5,170
Foundation
110,306
2,489
MCGOWAN
Combination HIV Antiretroviral
Rectal Microbicide Program
Federal
1,679,703
412,417
MCGOWAN
Microbicide Safety and
Acceptability in Young Men
Federal
1,403,289
214,102
MCGOWAN
Home HVTN Mucosal
Immunology Group Study
Federal
19,473
11,392
MCGOWAN
Phase 1, Assessment of TMC 278 LA
Foundation
1,830,373
183,037
MCGOWAN
High Risk Men; Identity, Health,
Risks and Stigma
Federal
23,909
14,107
MCGOWAN
Navigen Research Services
Agreement
Industry
3,864
966
MCGOWAN
Characterization of Anal Human
Papillomavirus Infection, Anal
Cytology and Anal Dysplasia in
UOP IBD Study
Comprehensive Evaluation of
Prolapse Meshes
Non
Federal
3,162
791
Federal
298,104
104,645
MOALLI
Impact of Vaginal Estrogen in
the Treatment of Symptomatic
Foundation
6,250
0
ORWIG
Characterization of Male
Germline SC Rhesus Infertility
Federal
559,526
143,334
ORWIG
Preservation of Male Fertility
Foundation
19,565
2,935
LINKOV
MOALLI
102
ORWIG
Germline Differentiated Human
Pluripotent Stem Cells
Federal
20,833
12,292
PETERS
Non-Invasive Detection Fetal
Aneuploidy Next Generation
DNA
Epigenomic Regulation of Gene
Expression in Diet Induce
Federal
341,541
111,274
Federal
44,168
22,747
Molecular Bases Committing
Primate Spermatogonia to a
Pathway of Differentiation
Mechanisms of Preeclampsia
Risk with Obesity: Role-Elev
ADMA
Genomic Basis of Premature
Ovarian Insufficiency
Federal
279,563
108,424
Federal
267,352
53,551
Federal
450,774
173,790
Self-Administered Intravaginal
2% Lidocaine Gel Prior to IUD
Insertion in Nulliparous Women
Contraception
Foundation
17,453
0
Foundation
54,603
0
PRE-EMPT "Pre-eclampsia,
Eclampsia, Monitoring,
Prevention
Oxford University Conference
Meeting Pre-Empt
Foundation
153,629
15,363
Foundation
2,731
0
ROHAN
Microbicide properties of RT
inhibitor Combinations
Federal
17,815
10,422
ROHAN
Aminoglycoside Microbicides
Restore Natural Expression of
anti-HIV-1 retrocylins
Release Assays from EVA Rings
Federal
10,899
6,430
Federal
116,408
59,750
Development of a Novel
Nanoparticle Pyrimidinedione
Vaginal
Films as a Vaginal Drug Delivery
Platform
Federal
26,284
15,376
Foundation
659,017
98,851
Exploring HIV-Host Interactions
in the Female Reproductive
System
Thermostable Vaginal Probiotic
Microbicide
Federal
39,501
23,306
Federal
76,423
45,090
Magee-Womens Basic and
Translational Reproductive
Federal
453,270
21,931
PETERS
PLANT
POWERS
RAJKOVIC
RAPKIN
RAPKIN
ROBERTS
ROBERTS
ROHAN
ROHAN
ROHAN
ROHAN
ROHAN
SADOVSKY
103
Health Training Program
SADOVSKY
Placental Injury and MicroRNA
Federal
258,361
41,040
SADOVSKY
Small RNAs at the Placental
Maternal Communication
Interface
Molecular and Cellular Controls
of Placental Metabolism
Federal
156,170
60,473
Federal
865,718
131,444
Building Interdisciplinary
Research Careers in Women's
Health (BIRCWH)
Primary Human Trophoblasts
and the Transfer of Viral
Resistance
SonoHSG for the Asssement of
Fallopian Tube Patency
Federal
495,213
4,786
Federal
460,288
31,713
Industry
7,360
1,840
Phosphodiesterase-3B Signaling
in the Hypothalamus and
Obesity
HIV-1 Associated Dementia:
Concomitant Roles of Vpr & Cell
Federal
211,557
108,952
Federal
28,719
16,259
SCHATTEN
Frontiers In Stem Cells in
Cancer
Federal
301,222
22,855
SCHATTEN
Nicotine Dysregulates Lung
Differentiation through N-my
Federal
7,211
3,714
SCHATTEN
Rehabilitative and Regenerative
Medicine for Minority Health &
Health Disparities
Frontiers in Aging and
Regeneration Research (FrARR)
Federal
126,210
8,764
Federal
356,667
23,333
SCHAFFER
Fellows Educational Fund
Foundation
600
0
SIMERLY
Tobacco funds 2013
State
145,450
29,090
SIMHAN
Preterm Birth in Nulliparous
Women: An Understudied
Population at Great Risk
Preterm Birth in Nulliparous
Women: An Understudied
Population at Great Risk CAPITATION
Vitamin D: A Link to Racial
Disparities in Birth Outcomes
Federal
186,905
69,745
Federal
342,578
84,114
Federal
105,131
54,583
SADOVSKY
SADOVSKY
SADOVSKY
SANFIlLIPPO
SAHU
SCHATTEN
SCHATTEN
SIMHAN
SIMHAN
104
SIMHAN
NuMoM2b Sleep Disordered
Breathing Substudy-Cap Study
Federal
78,149
32,693
SIMHAN
nuMoM2b Sleep Breathing
Study
Federal
16,956
9,919
SIMHAN
Factors Contributing to Oral
Health Disparities in Appalachia
Federal
30,113
17,616
SIMHAN
Sleep Disturbance & Risk for
Adverse Pregnancy Outcomes
Federal
42,682
25,183
SIMHAN
Maternal Obesity, Weight Gain,
& the Black-White Disparity
Federal
6,269
3,229
SIMHAN
Relationship of Loss of Control
Eating to Excessive Ges.
Federal
5,156
2,656
SIMHAN
Neurobiology and Cognitionl in
Early Onset Schizophrenia
Federal
3,811
1,963
SIMHAN
Maternal Vitamin D. Status and
Perterm Birth
Federal
31,876
16,417
SIMHAN
and the Black-White Disparity
Federal
26,052
6,457
SIMHAN
and the Black-White Disparity
Foundation
16,358
1,145
SIMHAN
Maternal Obesity, Weight Gain
& the Black-White Disparity
Federal
8,500
5,015
SIMHAN
Neurobiology and Cognition in
Early Onset Schizophrenia
Federal
4,941
2,890
SIMHAN
Stress & Cortisol Measurement
for the Nat'l Childrens' Study
Federal
110,881
65,420
SKAZNIK-WIKEL
Female Fertility Preservation
after High Dose Alk-Chem & GCS
Foundation
25,000
0
UPDIKE
Same Day Insertion of IUDs or
Implants for Women Seeking
Federal
1,524
785
VLAD
Disease Heterogeneity and
Immune Biomarkers in
Preclinical Mouse Models of
Ovarian Carcinogens
MUC1 Roles in Ovarian Cancer
Pathogenesis and Immune
Therapy
UPMC Sexually Transmitted
Infections Coop Research
Project (Project 1/Core B)
UPMC Sexually Transmitted
Infections Coop Research
Project-Supplement
Federal
145,000
16,120
Federal
236,133
51,260
Federal
642,579
364,299
Federal
22,542
13,300
VLAD
WIESENFELD
WIESENFELD
105
WIESENFELD
Phase II Study of Fluconazole vs
Fluconazole + MGCD290
Industry
65,500
16,375
WIESENFELD
CDC TFI Study
Federal
115,040
67,254
YANOWITZ J
Aging and Meiosis in the
Nematode Germline
Federal
52,908
4,233
YANOWITZ J
MOD - Meiotic Crossover
Formation (ID study)
Foundation
68,182
6,818
YANOWITZ J
Characterization of a Meiotic
Crossover Surveillance System
Federal
236,864
48,441
YATSENKO, A
Genetic Basis of
Oligozoospermia in Infertile
Males
Tobacco funds 2013
Federal
116,427
9,314
State
69,736
13,947
ZELEZNIK
Cyclic AMP signaling in
granulosa cells
Federal
174,709
89,975
ZYCZYNSKI
Urinary Incontinence Treatment
Network
Federal
12,478
5,983
ZYCZYNSKI
Pittsburgh Pelvic Floor Research
Program
Federal
239,577
77,294
37,178,321
11,115,886
YATSENKO, A
TOTAL
*For any new grants awarded in FY14, the amounts shown represent the first year of funding.
106
FUNDED RESEARCH ACTIVITIES
FY07-FY12
DIRECTS
FY07
FY08
FY09
FY10
FY11
FY12
FY13
Federal
17,427,857
20,300,955
25,060,501
25,859,781
31,085,451
35,255,580
33,385,221
Non Federal
3,790,746
4,116,838
3,705,694
6,899,925
3,547,819
3,199,125
5,041,101
Total
21,218,603
24,417,793
28,766,195
32,759,706
34,633,270
38,454,705
38,426,322
FY07
FY08
FY09
FY10
FY11
FY12
*Pitt Included
INDIRECTS
FY13
Federal
5,279,440
5,264,228
6,154,400
7,480,618
9,044,596
9,275,042
9,767,240
Non Federal
455,980
535,996
684,462
789,504
707,579
529,152
785,720
Total
5,735,420
5,800,224
6,838,861
8,270,121
9,752,175
9,804,194
10,552,959
*Pitt Included
107
Department of OBGYN
Funded Research Activities, in dollars
FY03-FY13
45,000,000
40,000,000
35,000,000
Direct Funding
30,000,000
25,000,000
Federal
20,000,000
15,000,000
10,000,000
5,000,000
FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13
108
PUBLICATIONS (FY10-FY13)
Abdool Karim, SS, Richardson BA, Ramje G, Hoffman IF, Chirenje ZM, Taha T, Kapina M,
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Achilles SL, Reeves, MF, Society of Family Planning Clinical Guidelines for the Prevention of
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Ackerman WE 4th, Bulmer JN, Carter AM, Chaillet JR, Chamley L, Chen CP, Chuong EB, Coleman
SJ, Collet GP, Croy BA, de Mestre AM, Dickinson H, Ducray J, Enders AC, Fogarty NM, Gauster M,
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Akers A, Yonas M, Burke J, Chang JC, Do you want somebody treating your sister like that?”:
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Akers AY, Holland CL, Bost JE, Interventions to improve parental communication about sex: A
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Akil, A., Parniak, M.A., Dezzutti, C.S., Moncla, B.J., Cost, M.R., Li, M., and Rohan, L.C.
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Albo ME, Litman HJ, Richter HE, Lemack GE, Sirls LT, Chai TC, Norton P, Kraus SR, Zyczynski HM,
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Alcin E, Sahu A, Ramaswamy S, Hutz ED, Keen, KL, Terasawa, E, Bethea CL, Plant TM,
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Bradley MS, Kaminski RJ, Streitman DC, Dunn SL, Krans EE. Effect of rotation on perineal
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Bruce YL, Wiringa AE, Abena N, Afriyie JS, Bailey RP, Beigi RH. Routine Staphylococcus aureus
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Calderon MR, Verway M, An BS, DiFeo A, Bismar TA, Ann DK, Martignetti JA, Shalom-Barak T,
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Caritis SN, Zhao Y, Bettinger J, Venkataramanan R. Qualitative and quantitative measures of
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114
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Caritis SN. Metaanalysis and labor inhibition therapy. Am J Obstet Gynecol. 2011 Feb;
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Caritis SN, Simhan H. Cervical pessary use and preterm birth: how little we know. Lancet. 2012
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22475492.
Caritis SN, Simhan HN, Zhao Y, Rouse DJ, Peaceman AM, Sciscione A, Spong CY, Varner MW,
Malone FD, Iams JD, Mercer BM, Thorp JM Jr, Sorokin Y, Carpenter M, Lo J, Ramin SM, Harper
M; Eunice Kennedy Shriver National Institute of Child Health and Human Development
Maternal-Fetal Medicine Units Network. Relationship between 17-hydroxyprogesterone
caproate concentrations and gestational age at delivery in twin gestation. Am J Obstet Gynecol.
2012
Caritis SN, Sharma S, Venkataramanan R, Rouse DJ, Peaceman AM, Sciscione A, Spong CY,
Varner MW, Malone FD, Iams JD, Mercer BM, Thorp JM Jr, Sorokin Y, Carpenter M, Lo J, Ramin
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Urinary Incontinence Treatment Network, Correlates and predictors of patient satisfaction with
drug therapy and combined drug therapy and behavioral training for urgency urinary
incontinence in women. Int Urogynecol J Pelvic Floor Dysfunct, 22(3): 327-334, 2011.
Varum S, Rodrigues AS, Moura MB, Momcilovic O, Easley CA 4th, Ramalho-Santos J, Van Houten
B, Schatten G, Energy metabolism in human pluripotent stem cells and their differentiated
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Varum S, Rodrigues AS, Moura MB, Momcilovic O, Easley CA 4th, Ramalho-Santos J, Van Houten
B, Schatten G, Energy metabolism in human pluripotent stem cells and their differentiated
counterparts. PLoS One, 6(6): e20914, 2011.
Vitek W, Akers A, Meyn LA, Switzer GE, Lee BY, Beigi RH. Vaccine eligibility and acceptance
among ambulatory obstetric and gynecologic patients. Vaccine 2011;29(11):2024-28. PMID:
21272604.
Vogel BE, Wagner C, Paterson JM, Xu X, Yanowitz J. 2011. An extracellular matrix protein
prevents cytokinesis failure and aneuploidy in the C. elegans germline. Cell cycle, 10(12): 1916 –
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von Dadelszen P, Sawchuck D, Hofmeyr GJ Magee LA, Bracken H, Mathai M, Tsigas EZ, Teela KC,
Donnay F, Roberts JM on behalf of the PRE-EMPT Steering Committee. PRE-EMPT (PREeclampsia-Eclampsia Monitoring, Prevention and Treatment): a low and middle-income country
initiative to reduce the global burden of maternal, fetal and infant death and disease related to
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Health, in press, 2013.
von Dadelszen P, Firoz T, Donnay F, Gordon R, Hofmeyr GJ, Lalani S, Payne BA, Roberts JM, Teela
KC, Vidler M, Sawchuck D, Magee LA. Preeclampsia in low and middle-income countries—Health
services lessons learned from the PRE-EMPT (PRE-Eclampsia-Eclampsia Monitoring, Prevention
& Treatment) project. Journal of Obstetrics and Gynaecology Canada, 34(10): 917-926, 2012.
von Dadelszen P, Ansermino JM, Dumont G, Hofmeyr GJ, Magee LA, Mathai M, Sawchuck D,
Teela K, Donnay F, Roberts JM; PRE-eclampsia-Eclampsia Monitoring, Prevention and Treatment
Group. Improving maternal and perinatal outcomes in the hypertensive disorders of pregnancy:
a vision of a community-focused approach. International Journal of Gynecology & Obstetrics,
119 Suppl 1: S30-4, 2012.
Wai CY, Curto TM, Zyczynski HM, Stoddard AM, Burgio KL, Brubaker L, Rickey LM, Menefee SA;
Urinary Incontinence Treatment Network. Patient satisfaction after midurethral sling surgery
for stress urinary incontinence. Obstet Gynecol. 2013 May;121(5):1009-16
Wakim AW, Complex X chromosome rearrangement delineated by array comparative genome
hybridization in a woman with premature ovarian insufficiency. Fertility & Sterility, 95(7):
2433,E9-15, 2011.
Wakim AW, Random-start gonadotropin-releasing hormone (GnRH) antagonist-treated cycles
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Wakim AW, Is a premature rise in luteinizing hormone in the absence of increased progesterone
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Wang, L., Schnaare, R.L., Dezzutti, C., Anton, P.A., and Rohan, L.C. Rectal microbicides: clinically
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2012 OBSTETRICS AND GYNECOLOGY RESIDENCY GRADUATES
RESIDENCY TRAINING PROGRAM
Residency Training Program in Obstetrics & Gynecology
We continue to attract the very top candidates from medical schools nationally and were
successful in this year’s Match. During the 2013 interview season, we screened 569 applicants
(406 from LCME schools with 25 of these from osteopathic schools, and 163 international
medical graduates), invited 122 to interview and ultimately interviewed 103 prospective
residents.
Following is an NRMP/AAMC summary of U.S. senior medical students that our program
matched compared to the number of U.S. seniors medical students that matched in Obstetrics
and Gynecology during the last three years. As you can see, our program continues to surpass
the 75th percentile in each category.
Percentile Distribution for All Categorical Obstetrics and Gynecology Programs
2010
th
Percent AOA Membership
Mean Step 1 USMLE Score
Mean Step 2 USMLE Score
25
0
206
218
th
50
0
217
228
th
75
16.7
225
239
2011
UPMC
33.3
241
254
th
25
0
207
218
th
50
0
217
229
th
75
0
226
238
2012
UPMC
40.0
234
245
th
25
0
208
221
th
50
0
218
233
th
75
10
227
243
The 2012-2013 intern class filled the 10 spots. New rotations include the following. An
additional Labor Suite rotation for first year residents was added to allow residents to develop
labor management skills earlier in residency. One Gynecologic Oncology rotation was moved
from the first year to the second year, restoring the Onc team to 1 each of first, second, third
and fourth years. The MIS-Urogyn rotation was moved from the second to the third year to take
advantage of advanced surgical skill development at this level.
The residency continues to integrate use of the “backpack” virtual reality robotic surgery
simulator into the resident curriculum. Drs Donnellan and Gosman received grant funding to
purchase the MIMIC free standing virtual reality robotic simulator in 2013. This tool will allow
clinicians and trainees to develop, practice, and refresh console skills without disrupting the
clinical Operating Room schedule. This tool will be installed in the 2013-2014 academic year.
Multiple robotic surgery faculty participate as instructors for robotic simulation training for the
residents. The robotic and laparoscopic surgery simulation curriculum combined with surgical
experience make Magee one of the top ob/gyn residencies for preparation in minimally invasive
surgery.
During the past academic year, our residents were the recipients of the awards listed
below. Highlights of their accomplishments include several prize papers at national
meetings, and one resident who received the Gold Humanism “Little Apple” award. This
155
UPMC
40.0
235
254
is a remarkable accomplishment, as University of Pittsburgh M3 Medical students grant
this award to the 6 best resident teachers encountered during their M3 year, in all
specialties that host core clerkships
National Awards
Michell Boisen, MD (R4)

American Association of Gynecologic Laparoscopists - Special Excellence in
Endoscopic Procedures Award
R. Swati Shree, MD (R3)
 Society of Laparoscopic Surgeons - Outstanding Resident Award
Megan Bradley, MD (R3)
 American Urogynecologic Society - Award for Excellence in Female Pelvic
Medicine and Reconstructive MedicineMegan Bradley, MD
Frances Stafford, MD (R2)
 Society of Maternal-Fetal Medicine – Resident Award for Excellence in Obstetrics
Institutional Awards
Paula Duncan, MD
 University of Pittsburgh School of Medicine, Best Fourth-Year Ob/Gyn Resident
Teacher as selected by Third-Year Medical Students
Megan Bradley, MD
 University of Pittsburgh School of Medicine, Best Third-Year Ob/Gyn Resident
Tracy Gosen Clary, MD
 University of Pittsburgh School of Medicine, Best Second-Year Ob/Gyn Resident
Stephanie Rothenberg, MD
 University of Pittsburgh School of Medicine, Best First-Year Ob/Gyn Resident
Margaret Shramm, MD
 Gold Foundation Humanism and Excellence in Teaching (Little Apple Award)
To recognize the teaching efforts of all of our residents, the Department initiated
156
a Best Resident Teacher of Students for every medical student block.
This started during the second-half of the academic year and the recipients were as
follows:
Block 6:
Block 7:
Block 8:
Block 9:
Block 10:
Block 11:
Block 12:
Sheila Ramgopal, MD (PGY4)
Megan Bradley, MD (PGY3)
Jennifer Salati, MD (PGY4)
Paula Duncan, MD (PGY4)
Eirwen Scott, MD (PGY3)
Katherine Cook, MD (PGY3)
Leslie Moroz, MD (PGY4)
Chapters and Case Reports
Bodnar LM, Parrott MS. Interventional strategies to improve outcome in obese
pregnancy: micronutrients and supplements. Poston L, Gillman M, eds. Obesity and
Pregnancy. Cambridge, Cambridge University Press. Ch 16, pp. 199-208.
Published Articles - Peer Review Articles
Bradley MS, Kaminski RJ, Streitman DC, Dunn SL, Krans EE. Effect of rotation on perineal
lacerations in forceps-assisted vaginal deliveries. Obstetrics and Gynecology. 2013
Jul;122(1):132-137. PMID: 23743462.
Hinshaw HD, Smith A, Rungruang B, Kelley JL, Beriwal S, Krivak TC, Sukumvanich P,
Olawaiye AB. The risk of subsequent malignancies in women with uterine papillary
serous or clear cell endometrial cancers. Int J Gynecol Cancer. 2013 Jul;23(6):1044-9.
PMID: 23748174.
Hinshaw HD, Smith AL, Desouki MM, Olawaiye AB. Malignant transformation of a
mature cystic ovarian teratoma into thyroid carcinoma, mucinous adenocarcinoma, and
strumal carcinoid: a case report and literature review. Case Rep Obstet Gynecol. 2012;
2012:269489. PMID: 23029627.
Lee JK, Parisi SM, Baldauf E, Rapkin RB, Updike GM, Schwarz EB. Asking for what she
needs? Pregnancy testing or EC? Contraception. 2013 Jun;87(6):859-63. doi:
10.1016/j.contraception.2012.10.019. Epub 2012 Dec 4. PMID: 23218857.
Lesnock JL, Arnold RM, Meyn LA, Buss MK, Quimper M, Krivak TC, Edwards RP, Chang JC.
157
Palliative care education in gynecologic oncology: A survey of the fellows. Gynecologic
Oncology. 2013 May 18 [Epub ahead of print]. PMID: 23694719.
Smith AL, Scott EM, Krivak TC, Olawaiye AB, Chu T, Richard SD. Dual-console robotic
surgery: a new teaching paradigm. J Robot Surg. 2013 Jun;7(2):113-118. PMID:
23704858.
Scott EM, Smith AL, Desouki MM, Olawaiye AB. Epithelioid trophoblastic tumor: a case
report and review of the literature. Case Rep Obstet Gynecol. 2012;2012:862472.
PMID: 23243530.
Arden D, Seifert E, Donnellan N, Guido R, Lee T, Mansuria S. Intraperitoneal Instillation
of Bupivacaine for Reduction of Postoperative Pain After Laparoscopic Hysterectomy: A
Double-Blind Randomized Controlled Trial. J Minim Invasive Gynecol. 2013 May 21
[Epub ahead of print]. PMID: 23706546.
Snook ML, Nayak S, Lara-Torre E, Sanfilippo JS. Adolescent gynecology: special
considerations for special patients. Clinical Obstetrics and Gynecology. 2012
Sep;55(3):651-61. PMID: 22828097.
Abstract Presentations
Oral Presentations
Boisen M, Lesnock J, McBee W, Richard S, Kelley J, Beriwal S, Zorn K, Krivak T, Edwards RP.
CA125 Surveillance and Second-Line Intraperitoneal Platinum-Based Therapy Increases SecondLine Progression-Free Survival for Epithelial Ovarian Cancer. Eighth International Symposium on
Regional Cancer Therapies, February 16-18, 2013, Indian Wells, CA.
Boisen M, Lesnock J, Richard S, Krivak T, Chu T, Zorn K, Sukumvanich P, Edwards RP. Impact of
Modifications of the Standard Intraperitoneal/Intravenous Paclitaxel/Cisplatin Chemotherapy
Regimen on Progression Free Survival. Eighth International Symposium on Regional Cancer
Therapies, February 16—18, 2013, Indian Wells, CA.
Hinshaw H, Smith A, Rungruang B, Sukumvanich P, Olawaiye A. Are Type II Corpus Cancers
Associated with an Increased Risk of Metachronous Malignancies? Western Association of
Gynecologic Oncologists Annual Meeting, June 27-30, 2012, Huntington Beach, CA.
Ecker A, Donnellan N, Shepherd J, Lee T. Abdominal Wall Endometriosis: A 10-year Experience at
a Large Academic Institution. AAGL Annual Meeting, November 2012, Las Vegas, NV.
158
Poster Presentations:
Quimper M, Lesnock J, Beriwal S, Krivak T, Olawaiye A, Lin J, Sukumvanich P. Comparison of
outcomes in patients undergoing rectosigmoid resection: End colostomy versus reanastomosis.
SGO Meeting, March 9-12, 2013.
Rowland M, Lesnock J, Edwards R, Richard S, Zorn K, Sukumvanich P, Krivak T. Occult uterine
cancer in patients undergoing laparoscopic hysterectomy with morcellation: implications for
surveillance for disease recurrence and outcomes. SGO Meeting, March 9-12, 2013.
Rowland M, Farris C, Lesnock J, Krivak T. Cost comparison of primary debulking surgery to
neoadjuvant chemotherapy for treatment of advanced stage ovarian cancer in patients ≥ 65
years old. SGO Meeting, March 9-12, 2013. (Featured Poster)
Shree R, Dunn S, Beigi R, Emery S, Krans E. What took so long? Factors associated with cesarean
section operative times greater than one hour. American College of Obstetrics and Gynecology
Annual Meeting. May 4-8, 2013. New Orleans, LA.
Shree R, Simhan H. Interpregnancy Interval and Anti-Inflammatory Cervical Cytokine Milieu
Among Women with Prior Preterm Birth. Society for Gynecologic Investigation Annual Meeting.
March 20-23, 2012. Orlando, FL.
Video Presentation:
Ecker A, Lum D, Lee T. Use of a Chicken Thigh Model to Teach Laparoscopic Electrosurgery.
November 2012 AAGL Annual Meeting, Las Vegas, NV.
Research Day Oral Presentations
Megan Bradley, MD. Impact of Rotation on Perineal Lacerations in Forceps-Assisted Vaginal
Deliveries. Research Advisor: Elizabeth Krans, MD.
Jennifer Salati, MD. The Effect of Body Mass Index on Sonographic Estimation of Fetal Weight at
Term. Research Advisor: Timothy Canavan, MD.
R. Swati Shree, MD. Role of Fetal Lung Maturity Testing in Patients with Preterm Premature
Rupture of Membranes. Research Advisor: Francesca Facco, MD.
Erin Seifert, MD. Assessment of Rates of Breastfeeding and Contraception in Group Versus
Individual Prenatal Care. Research Advisor: Elizabeth Krans, MD.
Serena Chan, MD. Adolescent Reproductive Health Counseling and Practice: Comparison
between Ob/Gyn, Family Medicine & Pediatric Residents. Research Advisor: Aletha Akers, MD.
Hilary Hinshaw, MD. Ten-year Experience with a Multidisciplinary High Risk Program. Research
Advisor: Kristin Zorn, MD.
159
Eirwen Scott, MD. Comparison of Surgical Site Complications and Lymphedema after Radical
Vulvectomy for Advanced Stage Vulvar Cancer in Patients Treated with Neoadjuvant
Chemoradiation and Primary Surgery: A Case Matched Series. Research Advisor: Paniti
Sukumvanich, MD.
Michelle Rowland, MD, PhD, MPH. Neoadjuvant Chemotherapy is Less Costly Than Primary
Debulking Surgery for Treatment of Advanced Stage Ovarian Cancer in Patients ≥ 65 Years Old.
Research Advisor: Thomas Krivak, MD.
Paula Duncan, MD. WASTE Survey: What Are Ob/Gyn’s Attitudes Toward Surgical Trash and the
Environment? Research Advisor: Noe Copley-Woods, MD.
Sheila Ramgopal, MD. Iodine Deficiency in Pregnant Women in Rural Haiti. Research Advisor:
Daniel Lattanzi, MD.
160
Tiffany L. Beck, MD
Full-Time Faculty, Department of Obstetrics, Gynecology &
Reproductive Sciences, University of Pittsburgh School of
Medicine, Magee-Womens Hospital of UPMC, Pittsburgh,
Pennsylvania
Heather I. Levin, MD
Fellowship, Maternal-Fetal Medicine, Columbia University
Medical Center, New York, New York
Michelle H. Moniz, MD
Medicine, Magee-Womens Hospital of UPMC, Pittsburgh,
Pennsylvania
Kiran M. Perkins, MD
Medicine, UPMC Mercy, Pittsburgh, Pennsylvania
G. Dante Roulette, MD
Fellowship, Robotics, Summa Health System, Akron, Ohio
Danielle L. Smith, MD, PhD
Private Practice, Western PA Women’s Health Care Associates,
Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania
Sarah E. Taylor, MD
Fellowship, Gynecologic Oncology, University of Pittsburgh
Medical Center Medical Education, Magee-Womens Hospital
of UPMC, Pittsburgh, Pennsylvania
Lindsay C. Turner, MD
Fellowship, Female Pelvic Medicine and Reconstructive
Surgery, University of Pittsburgh Medical Center Medical
Education, Magee-Womens Hospital of UPMC, Pittsburgh,
Pennsylvania
161
CLINICAL FELLOWSHIP
CLINICAL FELLOWSHIP
The department offers fellowship training in the following nine subspecialty areas of obstetrics
and gynecology: Female Pelvic Medicine and Reconstructive Surgery, Minimally Invasive
Gynecologic Surgery, Gynecologic Oncology, Family Planning, Medical Genetics, Reproductive
Infectious Diseases, Maternal-Fetal Medicine, Reproductive Endocrinology and Infertility, and
Global Health.
Female Pelvic Medicine and Reconstructive Surgery
The fellowship in Female Pelvic Medicine and Reconstructive Surgery at Magee-Womens
Hospital of the UPMC and the University of Pittsburgh is designed as a three-year curriculum for
individuals who have completed residency training in obstetrics and gynecology or urology. The
fellowship offers two positions per year. The curriculum is designed to provide broad training
and experience in clinical care and research in women with pelvic floor disorders. Clinical
rotations include in-patient and out-patient urogynecologic urology, geriatrics, colorectal
surgery and gastroenterology. Surgical approaches to pelvic floor disorders include abdominal,
vaginal and laparoscopic procedures. Research rotations will include the opportunity to
participate in both basic science (laboratory) research and clinical research. Fellows will have
the opportunity to apply for a Master’s degree and/or obtain a certificate from the Institute for
Clinical Research Education. Clinical experience in obstetrics is available but nor required as part
of the fellowship. Director: Pamela Moalli, MD
Minimally Invasive Gynecologic Surgery
The Department has a two-year intense academic training program which focuses on minimally
invasive gynecologic surgery. The program is designed to provide extensive training in
endoscopic surgery from the gynecologic and general surgery perspectives. A research project is
an integral part of the program with the expectation that it is submitted at a national level and
published in a peer-review journal. Other activities include active participation in resident and
student teaching programs and private patient sessions. Director: Ted Lee, MD
Gynecologic Oncology
An American Board of Obstetrics and Gynecology (ABOG) approved fellowship. There are two
positions per year for a three-year fellowship in Gynecologic Oncology. Fellows obtain advanced
clinical and research training, with participation in the core Clinical Research Training Program.
In addition, a variety of tracks are available should the fellow wish to pursue a Master’s of
Science in Clinical Research. Fellows will gain exposure To NIH- funded trials through the
Gynecologic Oncology Group (GOG), Radiation Therapy Oncology Group (RTOG) and many other
162
CLINICAL FELLOWSHIP
ongoing clinical and basic research Departments of Obstetrics and Gynecology, Radiation
Oncology and Surgical Oncology (at UPMC Shadyside) Director: Thomas Krivak, MD
Family Planning
This fellowship is one of only a few funded fellowships in family planning in the United States.
This two-year fellowship is designed to include training in family planning clinical care,
experience in gynecologic surgery and related family planning procedures, participation in the
design and performance of clinical trials and international field work. During the two years, the
fellow is encouraged to complete coursework at the Graduate School of Public Health at the
University of Pittsburgh to satisfy the requirements of a Master’s degree in Public Health.
Coursework can involve a multidisciplinary approach or a departmental curriculum including
biostatistics, epidemiology and health care administration. The program is intended to foster
the pursuit of an academic career by an overall emphasis on and preparation for clinical
research and teaching. The fellow will be specially trained in contraceptive counseling,
Implanon insertion and removal, IUD insertion and removal and the fitting of diaphragms.
Additionally, the fellow will gain expertise in treating complications of hormonal contraception.
Although these procedures may have been learned during residency, a concentrated experience
will enable the fellow to be proficient with unusual or complicated cases. The fellow will receive
specialized training and become very experienced in performing first trimester procedures
including manual vacuum aspiration and medical abortions. The fellow will have similar
experience with second trimester abortions by dilation and evacuation (D&E). Director:
Medical Genetics
The department has a two or three-year fellowship program in Medical Genetics and offers one
position per year. The program focuses on methods of fetal diagnosis and therapy, natural
history of fetal malformations, and role of heredity in gynecologic cancer. A broad base of
clinical and laboratory training is offered. Director: Aleksander Rajkovic, MD
Reproductive Infectious Disease
The Reproductive Infectious Disease fellowship trains obstetrician-gynecologists to become
experts in infections of the reproductive tract. It is a two-year fellowship which offers one
position every other year. The program focuses on infectious diseases in obstetric and
gynecologic patients but includes exposure to medical infectious disease, STD’s and neonatal
infections. Exposure to current laboratory techniques in microbiology, molecular biology and
immunology is also offered as well as biostatistics and epidemiology. The fellows’ efforts in
163
CLINICAL FELLOWSHIP
basic science and clinical investigation are also fostered and expected.
Wiesenfeld, MD
Director:
Harold
Maternal-Fetal Medicine
An approved fellowship in MFM offers three positions per year. Extensive clinical training is
provided using the large obstetrical population of 400+ maternal transport patients per year.
Experience in ultrasound, reproductive genetics, neonatology and statistical methodology is part
of the training. Basic research in cardiovascular physiology, pharmacology, infectious diseases,
and molecular biology are available through the Magee-Womens Research Institute. Areas of
clinical research focus include: preterm birth prevention, pharmacologic agents for the
inhibition of labor, infectious diseases, preeclampsia and medical complications of pregnancy.
Director: Steve N. Caritis, MD
Reproductive Endocrinology and Infertility
The University of Pittsburgh fellowship program in Reproductive Endocrinology and Infertility
addresses all aspects of The American Board of Obstetrics & Gynecology (ABOG) requirements
for subspecialty training. This three-year program offers one position per year. Particular
emphasis is placed on surgical training spanning from pediatric to adult patients. Issues related
to the specialty will be addressed with detailed faculty supervision with regard to didactic,
medical surgical and assisted reproductive technology aspects of specialty training. Director:
Joseph S. Sanfilippo, MD
Global Womens Health
This two year fellowship in Global Women’s Health will provide the opportunity to gain
experience and knowledge of women’s global health in the area of direct patient care, research
and policy implementation. The fellowship will create leaders who will develop educational
initiatives, improve clinical services and promote research in international reproductive health.
Clinical training will emphasize medical issues unique to low resource populations such as
tropical diseases, malnutrition, HIV/AIDS etc. Fellows will gain experience in grant writing,
budgeting, and the administrative aspects of clinical research while designing and conducting a
research trial with the goal of publishing. In addition to the clinical and research obligations of
the fellowship, the fellow is encouraged to complete coursework at the Graduate School of
Public Health at the University of Pittsburgh to satisfy the requirements of a Master’s degree in
Public Health. Director: Miriam Cremer, MD, MPH
164
CLINICAL FELLOWSHIP
165
CLINICAL REVENUE DATA AND TRENDING
2013
(in thousands)
FYE13 Actual
Net Patient Care Revenue
$72,210
UPMC Support Revenue
25,583
Investment Earnings on Endowments*
218
Misc Operating Revenue
2,392
Total Other Operating Revenue
28,193
Total Operating Revenue
$100,403
Physician Salary Expense
$41,163
Physician Incentive Expense
3,966
Staff Salary Expense
18,811
Fringe Benefits - Physician
5,386
Fringe Benefits - Staff
5,053
Total Salaries and Benefits
74,379
Other Direct Operating Expenses
Supplies Expense
4,885
Rent Expense
4,686
Malpractice/Professional Liability Expense
5,175
Other Expenses
3,482
Total Other Direct Operating Expenses
18,228
UPP Billing Overhead (4.6% NPR)
3,322
166
Staff FTEs
2013
UPP Corporate Overhead Allocation (1.6% Total Revenue)
1,606
Total Expenditures
$97,535
Income from Operations
$2,868
Physician Headcount
179
Staff FTEs
455
UPP, Womens Health Dept - FY13, recap of EPIC Billing activity
FY 13' Charges by Division
General OB/GYN (3.5%)
General OB/GYN, HospitalBased (23.7%)
Genetics (.4%)
Gynecologic Specialities/MLC
(7.9%)
Gynecological Oncology (8.2%)
Nurse Mid-Wives (1.3%)
Obstetrical Services/MFM (6.0%)
REI/IVF (6.6%)
Ultrasound (10.3%)
Urogynecology (4.0%)
167
FY 13' NPR/Payments by Division
2013
General OB/GYN (3.5%)
General OB/GYN, HospitalBased (24.2%)
Genetics (.3%)
Gynecologic Specialities/MLC
(5.5%)
Gynecological Oncology (6.0%)
Nurse Mid-Wives (1.6%)
Obstetrical Services/MFM
(5.7%)
REI/IVF (9.8%)
Ultrasound (8.1%)
Urogynecology (2.6%)
WCA based OB/GYN groups
168

department of obstetrics, gynecology, and reproductive sciences

Transcription

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