ACOOG 2015-2016 Board of Trustees

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ACOOG 2015-2016 Board of Trustees
c o m m i t m e n t
e x c e l l e n c e
“ACOOG is passionately committed to excellence in women’s health.
With integrity, we shall educate and support osteopathic health care
professionals to improve the quality of life for women. In doing so, we
will provide opportunities for fellowship and joy in our profession.”
Ye a r o f 2 0 1 5
Inside This Issue
President’s Message . . . . . . . . . . . . . . . . . . . . . . . . . 2
ACOOG 2015-2016 Board of Trustees . . . . . . . . . . 4
Executive Vice President’s Message . . . . . . . . . . . . 6
CME ARTICLE “INTERSTITIAL CYSTITIS: CURRENT RECOMMENDATIONS WITH A FOCUS ON
FIRST LINE THERAPY ” . . . . . . . . . . . . . . . . . . . . . . 7
2015 Fall Conference Highlights . . . . . . . . . . . . . . 18
ACOOG Membership News . . . . . . . . . . . . . . . . . . . . 19
Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
83rd Annual Conference . . . . . . . . . . . . . . . . . . . . . . 26
i n t e g r i t y
American College
of O steopathic
O bstetricians
&
G ynecologists
Winter Edition
Message from the
President
Eric J. Carlson, DO, FACOOG (Dist.)
Greetings to my ACOOG Family,
The ACOOG President is asked to send a message
along to the membership with the publication of
each newsletter. I am taking this opportunity to
express my great affection for the ACOOG and
its members. I have met so many altruistic and
committed individuals during my time serving the
ACOOG, that it has truly changed my life…it has
changed how I look at my place in my hospital and
my community, and it has made me a better person.
I became involved with service to the ACOOG
through an informal invitation by Laura Dalton,
DO, Chair of the ACOOG Continuing Medical
Education Committee (CMEC) at that time, to help
put a conference together. Dr. Dalton was one
of my mentoring attendings from my residency
days. I knew at the time neither that Dr. Dalton
was involved in service to the ACOOG-CMEC,
nor what the ACOOC-CMEC was. After “signing
on” to the CMEC crew, I learned that it is truly
a hive of busy bees. Those not a part would be
surprised as to how much work actually goes into
the construction of a conference, as well as the
level of details considered…ie. making sure that a
wide variety of topics are presented; finding topnotch speakers who are knowledgeable, engaging
and available to speak; calculating the perfect
blend of lecture length and content material to
keep the audience interested; making sure there
is an appropriate number of CME hours available
for conference attendees; presenting unique social
events to take advantage of each venue at hand;
the logistics of maximizing the cost of coffee and
snack services (very expensive) during breaks in
the program; the distance of the bathrooms to the
lecture hall; distance of the airport to the hotel
venue; likelihood that a direct flight can be made
to the venue; and on and on and on. I learned that
much energy, and frequently debate, goes into
calculating even the very minutest of details. The
CMEC appreciates feedback from the conference
attendees, but I have found that much of the
feedback we have received concerns issues that
have already been meted out ad nauseum during
committee work.
When I reflect on my involvement of service to the
ACOOG, I have realized that the ACOOG is not
some distant group of beaurocrats whose mission is
to make my life more difficult...which can be easy
to think. It is a group composed of obstetriciangynecologists who practice medicine just like I
do, and who work together to make sure that we
are all well represented nationally, that we have
the resources available to practice evidence-based
medicine, and we are best able to acclimate to the
process of osteopathic continuous certification
AND the ACGME single unified accreditation
system.
I have found that being a part of the ACOOG
has transformed me from a somewhat skeptical
observer to a caretaker and steward. My
involvement has greatly helped my understanding
with the technical processes of my professionial
life (the OCC process, board certification, CME
requirements, et cetera). My service to the
ACOOG has benefited not only the ACOOG, but
myself as well…which has truly surprised me. I
am grateful that I became involved in service to
the ACOOG…and I am likewise grateful that I
happened to know someone involved in service
who thought of me when she needed help.
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Message from the President
(Continued from Page 2)
I would like you to consider this an invitation
to become involved, yourself. There are many
opportunities within the ACOOG to give of
yourself. The following are committees that can
use dedicated, thoughtful volunteers…(and there
are also a number of ad hoc committees that need
help as well):
1- Bylaws Committee
2- Continuing Medical Education Committee
3- Editorial Committee
4- Ethics and Professional Standards Committee
5- Finance Committee
6- Government Affairs Committee
7- History and Traditions Committee
8- Investment Committee
9- Membership and Promotions Committee
10- Postgraduate Evaluation and Standards
Committee
11- Postgraduate Evaluation and Standards
Subspecialty Subcommittees
11- Research and Awards Committee
12- Strategic Planning Committee
2015-2016 Board of Trustees
Eric Carlson, DO. . . . . . . . . . . . President
James Perez, DO. . . . . . . . . President-Elect
David J Boes, DO . . . . . . . .. .Vice President
Thomas Alderson, DO.. . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . Immediate Past President
Jeanine McMahon, DO. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .Secretary-Treasurer
Catherine Bernardini, DO . . . . . . . . Trustee
Britney Bunot, DO . . . . . . . . . . . . .
. . . . . . . . . . . . . . . Resident Representative
Octavia Cannon, DO. . . . . . . . . . . . Trustee
Thomas Dardarian, DO. . . . . . . . . . Trustee
David Jaspan, DO . . . . . . . . . . . . . . Trustee
Jeffrey C. Koszczuk, DO. . . . . . . . . Trustee
Mark LeDuc, DO . . . . . . . . . . . . . . .Trustee
Timothy McGuinness, DO. . . . . . . Trustee
Marydonna Ravasio, DO. . . . . . . . . Trustee
Patrick Woodman, DO. . . . . . . . . . . Trustee
Michael J. Geria, DO . . . . . . . . . . . . . . . . . .
Executive Vice President (Ex-Officio)
William Bradford, DO . .
. . . . . . . . . . . . .Vice President of Evaluation
Valerie Bakies Lile, CAE. . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . Executive Director
Get started by contacting the ACOOG to volunteer:
8851 Camp Bowie West, Suite 275
Fort Worth, Texas 76116
Phone: 817-377-0421
Toll Free: 1-800-875-6360
Or email: [email protected]
Yours fraternally,
Eric J. Carlson, DO, MPH, FACOOG (Dist.)
ACOOG-President 2015-2016
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ACOOG
2015-2016 Board of Trustees
Eric Carlson, DO, FACOOG (Dist.)
President
James Perez, DO, FACOOG (Dist.)
President-Elect
Thomas Alderson, DO, FACOOG (Dist.)
Past President
Catherine Bernardini, DO, FACOOG (Dist)
Trustee
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David J Boes, DO, FACOOG (Dist.)
Vice President
Jeannine McMahon, DO, FACOOG
Secretary-Treasurer
Britney Bunot, DO
Resident Representative
Octavia Cannon, DO, FACOOG (Dist.)
Trustee
2015-2016 Board of Trustees
(Continued from Page 4)
Thomas Dardarian, DO,
FACOOG (Dist.)
Trustee
David Jaspan, DO, FACOOG
Trustee
Timothy McGuinness, DO,
FACOOG (Dist.)
Trustee
Michael J. Geria, DO, FACOOG (Dist.)
Executive Vice President
Jeffrey C. Koszczuk, DO,
FACOOG
Mark LeDuc, DO, FACOOG
Trustee
Marydonna Ravasio, DO, FACOOG
Trustee
Patrick Woodman, DO, FACOOG (Dist.)
Trustee
William Bradford, DO, FACOOG (Dist.)
Vice President for Evaluation
Valerie Bakies Lile, CAE, FACOOG (Hon.)
Executive Director
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Message from the
Executive Vice President
Michael J. Geria, DO, FACOOG, (Dist.)
Dear Colleagues,
It is hard to believe that another year is at an end.
This year marks several milestones, the most
prominent being the retirement of our friend and
colleague Steve Buchanan, DO, FACOOG(Dist).
Dr. Buchanan served the ACOOG in multiple
capacities for over twenty years. He leaves a legacy
of growth and prosperity for the college. The past
few weeks since assuming the job of Executive
Vice President and CEO have been filled with
much excitement on my part. Many thanks to our
Executive Director, Valerie Bakies-Lile and the
entire ACOOG staff who have been invaluable to
me during this transition period.
The other milestone is the initiation of the Single
Accreditation System. You are all aware that the
idea of the SAS was brought to reality last year but
the process did not begin until this past July. There
are still many uncertainties and I am sure bumps
in the road. I am confident that our Osteopathic
interests will be well represented by Drs. Glines
and Jaspan at the OB/GYN RC level.
As we move into 2016, our college and the
Osteopathic profession will face new challenges.
For as long as most of us can remember, much
of what defined us as Osteopathic Physicians
were our Osteopathic residency training
programs. Over the next four years the American
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steopathic Association will divest itself of
residency oversight. We as a profession and as an
organization must seek new avenues in which to
maintain our Osteopathic philosophy and heritage.
Although at first glance, it may seem challenging,
there is safety in numbers. Soon, one out of every
four medical school graduates in the United States
will be an Osteopathic Physician.
Our college is strong and continues to offer quality
and innovative CME. The membership continues
to grow not only in terms of residency graduates
but also in terms of student members. The Fall
Conference set yet another record for attendance.
Congratulations to program chairs Dr Glen Bigsby
and Dr Jim Lindemulder along with Dr Tom
Dardarian and the CME Committee.
In closing, best wishes for a safe and happy holiday
season, and a prosperous new year. See you in Ft
Lauderdale!!
Sincerely,
Michael J. Geria, DO, MS, FACOOG(Dist)
Interstitial Cystitis: Current Recommendations with a Focus
on First Line Therapy
Betsy Greenleaf, DO, FACOOG.
Introduction
In 1808, Dr Phillip Syng Physick, recognized “an
inflammatory condition of the bladder producing
the same lower urinary tract symptoms as a bladder
stone.” Dr Alexander Skene coined the term,
“Interstitial Cystitis” In 1887. Dr Guy Hunner
published 5 cases of urgency/frequency with
“Hunner’s” ulcers in 1915. Dr. Hermon Bumpus,
in 1930, was the first to describe hydrostatic
distension of the bladder under general anesthesia
for the diagnosis and treatment of IC. In 1978,
Dr’s Messing and Stamey published “Interstitial
cystitis: Early diagnosis, Pathology, and
Treatment.”
Despite the recognition of Interstitial Cystitis
as a medical condition as early as 1808, there has
been little advancement of knowledge. Interstitial
Cystitis is difficult to diagnose because of its
similarity to other pelvic conditions and lack of
definitive testing. The goal of this article is to
review the current recommendations with a focus
on first line therapy.
American Urology Association
Recommendations:
In 2013, the American Urology Association
(AUA) performed a systematic review of Interstitial
Cystitis literature published between 1983
until 2009. Their goal was to create treatment
recommendations that were grounded in evidence
based research. They continue to periodically
review and update their recommendations
accordingly. In addition, the AUA has classified
Interstitial Cystitis by the name Painful Bladder
Syndrome.
The biggest change in the current
recommendations is allowing for a diagnosis
based on history alone. The diagnosis criteria
Urogynecologist at the New Jersey Urologic Institute
has been shortened from 6 months to 6 weeks of
irritative bladder symptoms in the absence of other
pathology such as infection or neoplasm. This
shortened time period to diagnosis prevents a delay
in treatment. Earlier time to treatment is to prevent
centralization of pain. Centralization occurs with
upregulation of neuroreceptors, neurochemicals,
and physical changes in the central nervous system
after persistent peripheral noxious stimulation.
This can occur in as little as three months.
Centralized pain is more challenging to treat.
AUA Treatment Guidelines:
1. First Line Therapy
a. Education about IC/PBD including that
there is no single cause or single treatment
for this condition. Treatment needs a
multidisciplinary and multimodality approach.
b. Self-care: For example staying well
hydrated, and avoiding possible dietary
triggers
c. Stress Reduction
2. Second Line Treatment
a. Physical Therapy or Manual Therapy
(Evidence Strength Grade A)
i. Avoidance of pelvic floor strengthening
b. Pain Management
c. Oral Medications
i. Amitriptyline ( Evidence Strength
Grade B)
ii. Cimetidine ( Evidence Strength Grade
B)
iii. Hydroxyzine (Evidence Strength
Grade C)
iv. Pentosan Polysulfate ( Evidence
Strength Grade B)
d. Bladder Instillations
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i. DMSO ( Evidence Strength Grade C)
ii. Heparin ( Evidence Strength Grade C)
iii. Lidocaine ( Evidence Strength Grade
B)
3. Third Line Therapy
a. Cystoscopy under anesthesia with short
duration, low pressure (Evidence Strength
Grade C)
4. Fourth-line Therapy
a. Intradetrusor botulinum toxin A (Evidence
Strength Grade C)
b. Trial of neurostimulation such as Interstim
(Evidence Strength Grade C)
5. Fifth Line Therapy
a. Cyclosporine A (Evidence Strength Grade
C)
6. Sixth Line Therapy
a. Major Surgery such as cystoplasty or
urinary diversion with or without cystectomy
(Evidence Strength Grade C)
7. Therapies that are no longer recommended
a. Long term antibiotic usage (Evidence
Strength Grade B)
b. Intravesical bacillus Calmette-Guerin
(Evidence Strength Grade B)
c. High Pressure, long duration bladder
hydrodistension (Evidence Strength Grade C)
d. Systemic long term glucocorticoids
(Evidence Strength Grade C)
Evaluation of Lower Urinary Tract Symptoms
Since there is no definitive testing for Interstitial
Cystitis, it is important to rule out treatable
conditions first. A proper history and physical
should be performed to evaluate for the possibility
of systemic inflammatory conditions, infections,
neurologic disorders, back/spinal conditions,
urinary tract pathology, gastrointestinal disease,
and pelvic/genital conditions. The patient’s history
should help direct further evaluation. Patients with
previous radiation therapy should be evaluated
for radiation cystitis which will present similarly
to Interstitial Cystitis. A history of drug abuse
with ketamine can cause an irritative cystitis.
Tobacco use increases risk of bladder tumors.
Immunodeficient patients can develop cystitis from
polyomavirus. Lyme’s disease can also produce
irritative urinary symptoms.
To confuse matters further, there are limitations
in urine testing. Midstream clean catch samples
will not diagnosis urethral causes of irritation.
The best samples for bladder causes of infection
are those obtained midstream from first morning
urine. The predictive value of urine testing goes
down throughout the day as the patient hydrates
diluting any bacteria. Urinalysis dipstick has a low
overall sensitivity of 2.3%. Nitrate positive results
have the highest sensitivity 60.9%, specificity
100% and negative predictive value 85.2% in
patients with symptoms. Urine cultures can
produce false negatives, or positives dependent on
sample handling. In patients with lower urinary
symptoms it would be reasonable to initially treat
for an infectious cystitis. Cochrane reviews have
demonstrated that a three day antibacterial therapy
for uncomplicated urinary tract infections works
well for symptomatic cure. Longer therapies, such
as 5-10 days, produce more effective bacterial
cures.
Despite being listed as a third line therapy for
Interstitial Cystitis, this does not preclude the
use of cystoscopy. Cystoscopy is a reasonable
method of evaluation for bladder and urethral
pathology such as tumors, stones, diverticulae, and
urethritis. Urodynamic testing can be employed for
assessment of spasmodic conditions, low bladder
capacity, or other functional abnormalities.
Symptoms of urgency, frequency, dysuria, pelvic
pain, and pelvic pressure may be caused by non
urinary tract pathology. Consider evaluation for a
pelvic mass, vaginitis, gastrointestinal disorders,
and neurologic conditions
Theories of Interstitial Cystitis
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The pathologic process that causes Interstitial
Cystitis is unknown. Interstitial cystitis results
in a defect in the protective glycosaminoglycan
(GAG) layer of the bladder allowing urinary
irritants to cause bladder inflammation and pelvic
symptoms. Genetic and biochemical research
is being performed currently to evaluate altered
bladder epithelial expression of HLA Class I and
II antigens, decreased expression of uroplakin and
chondroitin sulfate, altered cytokeratin profile and
altered integrity of the glycosaminoglycan (GAG)
layer, defect in Tamm-Horsfall protein, increased
expression of interleukin-6 and P2X3 ATP,
activation of the NFkB gene, and the presence of
Antiprolierative factor.
Theoretical causes of Interstitial Cystitis
include viral, genetic, autoimmune, neurologic,
allergic disorders and gastrointestinal conditions.
Evaluation for pudendal neuralgia or back
pathology can determine a downstream reflex
sympathetic dystrophy that presents itself as
inflammation in the bladder. Leaky gut or intestinal
dysbiosis can cause a leaking of chemical irritants
into the system which may produce inflammation in
other organ systems. This may cause some patients
to present s with bladder complaints.
First Line Therapy
It is important to start first line therapy as soon
as possible. Research has demonstrated a
45% improvement in symptoms with first line
therapy (Foster HE J Urol 2010; 183: 1853). It
is reasonable to start first line therapy modalities
while evaluating the patient for other treatable
causes of pelvic complaints.
Education
Patients are often frustrated by chronic symptoms
with lack of a diagnosis. On the other hand, a
diagnosis can cause distress. Some patients are
upset by the label of an illness. The best strategy
is to educate the patient on this condition. There
exists a plethora of misinformation through
“Dr. Internet”. Caution patients about what
they read. Provide the patients with reliable
informative sources. Patients should understand
this is a multifactorial condition that requires a
team approach and motivation on their part to
successfully treat. Interstitial Cystitis is not going
to cause cancer or death. These tend to be the
most anxiety producing concerns. Good resources
include the American Urologic Association,
National Institute of Digestive and Diabetic and
Kidney Diseases, American Urogynecology
Society, International Pelvic Pain Society and the
Interstitial Cystitis Association. Caution should
be taken with chat rooms. Though chat rooms and
support groups can shield against isolation, there
have not been any conclusive studies that consumer
based chat rooms offer any benefit.
Exercise
Exercise can produce health benefits especially
in chronic pain patients. Educating the patient on
these benefits may help them to overcome any
initial lack of motivation to increase physical
activity. The patient should be made aware that
any new activity can initially aggravate pain and
discomfort. Patients should start low and slow. For
example, our institution will instruct patients to
begin with a part of their body that is not in pain,
such as the arms. Patients are instructed to increase
movement in the arms for 5 minutes three times
a week for 2 weeks. Exercise can be increased
by time or frequency; such as 5 minutes 5 times a
week or 10 minutes 3 times a week time 2 week.
Patients should consider increasing activity ever 2
weeks. Other options such as water based exercise
or aqua therapy may be more acceptable to some
patients.
Exercise has many positive influences
on the prevention of pain. Physical exercise
induces suppression in the TLR4 (toll like
receptor 4) signaling pathway. This receptor has
detrimental effects on immunity and worsening
of inflammation. Regular exercise activates
central inhibitory opioid pathways: the PAGRVM (Periaqueductal Gray Region to the Rostral
Ventromedial Medulla) responsible for the
transmission and sensation of pain. This area is
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also related to production of serotonin which plays
a role in analgesia. Exercise increases levels of
serotonin through other pathways and decreases
central excitability of pain receptors. It reduces
phosphorylation of NMDA glutamate receptors
in the brainstem. Glutamate is an excitatory
neurotransmitter that is release by noxious
peripheral stimuli. Exercise reduces CREB/
pCREB (cAMP response element-binding protein)
which has effects on hyperalgesia. Regulatory
macrophages which have a role in host defense
and healing are increased with exercise. They also
cause a blockade of interleukin 10R thus aiding in
analgesia.
Exercise studies have demonstrated both
immediate and long-lasting analgesia. The sooner
a patient can get involved in an exercise program
the more protective these neurochemical changes
can be.
Psychotherapy
It is not unusual to find pain patients that have a
high level of anxiety and depression. There is a
“chicken or egg’ theory to psychological disorders
in pain. Patients with a history of anxiety and
depression are more likely to experience pain
whereas patients in pain through neurochemical
changes can develop anxiety and depression.
Thus, addressing the psyche has not only shown
improvement in mood and outlook but have shown
reversal in pain scores and improvement in physical
and neurochemical changes.
Chronic pain can produce reduced volume
and density in cerebral gray matter. In a study
by Seminowicz et al., 13 patients with pain and
13 controls were assessed using voxel-based
morphometry to compare anatomic magnetic
resonance imaging scans of each group. The pain
patients were subjected to an 11 week protocol
of cognitive behavioral therapy. The pain group
demonstrated an increase in gray matter in the
“bilateral dorsolateral prefrontal, posterior parietal,
subgenual anterior cingulate/orbitofrontal, and
sensorimotor cortices, as well as hippocampus, and
reduced gray matter in supplementary motor area”
Gray matter increased above controls. Pain patients
demonstrated decreased pain catastrophizing, and
decreased report of pain.
Other studies have demonstrated that Cognitive
Behavioral Therapy alters the cerebral loop
between pain signals, emotions, and cognitions
leading to increased access to executive regions of
the brain responsible for reappraisal of pain.
Psychotherapy can also aid in treatment of
limbic associated pelvic pain. Chronic stimulation
of the limbic system by” pelvic pain afferents
produces an efferent contraction of the pelvic
muscles, thus perpetuating the cycle” (B.W.
Fenton). The muscle contraction is a splinting
process triggered by the protective limbic system.
However this is a defective system in pelvic pain
patients because it too can add to perceived pain.
Direct treatment of muscle spasms improves pain.
Psychotherapy has been shown to produce equal
results. Therefore combining physical treatment
along with psychological therapy has been
successful.
Diet
Diet has been a mainstay of Interstitial Cystitis
Treatment. Often practitioners will provide
patients with the “IC Diet”. Studies of patients
with diagnosed IC found that 11% of IC patients
don’t regularly eat the “bad” food but they still
have symptoms. Forty seven percent of IC
patients eat the “bad” food and don’t claim a
worsening of symptoms. The mechanism by which
foods cause irritative urinary symptoms has not
been proven through evidence-based medicine.
Theories of urinary pH affecting symptoms have
not been proven. Additionally, the ingestion of
acidic foods has not been shown to effect urinary
pH. Despite not being able to connect directly
the effects of acidic foods on urinary symptoms,
surveys of IC patients reveal the top irritative
offenders to be citrus fruits, tomatoes, vitamin C,
artificial sweeteners, coffee, tea, carbonated and
alcoholic beverages, and spicy foods. Calcium
glycerophosphate and sodium bicarbonate taken
orally have been shown to help relieve symptoms.
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The IC diet can provide an initial template
to follow. Food and symptom diaries may be
more beneficial in looking at dietary triggers in
individual patients. Teaming up with a functional
nutritionist can help in treatment of pain patients.
Diet and intestinal health can affect overall
body health. A functional gut provides immune
protection, nutrient uptake, and vitamin supply
to the body. Any disruption of the mucosal
protection of the gut can lead to absorption
of inflammatory agents resulting in systemic
inflammation, food intolerance, immune system
abnormalities, and autoimmunity. Malnutrition
and hypovitaminosis can lead to changes in nerves
that lead to neuropathy. Stress itself can affect the
digestive system causing a decrease in chewing
and hypochlorhydria which makes proteins more
difficult to digest. Stress causes effects on the
hypothalamic-pituitary-adrenal axis by causing
decreased gastric emptying and increased colonic
motility. Constipation and diarrhea can lead
to worsening of pelvic symptoms. Intestinal
symptoms can lead to elevated pelvic floor tone
and increased pelvic pain.
Dysbiosis, an elevation of harmful bacteria
and decrease in the healthy biome of the intestines
can lead to body inflammation and immunity
derangements. Increased levels of abnormal
bacteria can also stimulate Toll like Receptors
(TLR 4) adding to the pain response. Stress can
also effect the microbiome of the intestines.
Gliadin, even in those without gluten sensitivity,
can add to intestinal permeability. NSAIDS can
cause a reduction in probiotic bacteria. Fluid
restriction/dehydration can also have ill effects on
intestinal function and the microbiome.
Nutritional support to aid in stress and chronic
pain can include increasing omega fatty acids
and phosphatidylserine (found in fish) which can
aid in a decrease of stress hormones and cortisol
response. Omega 3 fatty acid has been shown
to decrease the perceived pain response. Sugars
should be reduced in the diet. Simple sugars can
increase cortisol and the risk of intestinal yeast,
which has been shown to convert tryptophan
to tryptophol thus decreasing the supply of
tryptophan that will convert to serotonin. Zinc can
improve intestinal lining integrity. Supplements
of lycopene, epigallocathechin gallate (green
tea extract), ellagic acid (pomegranate extract),
selenium and zinc have demonstrates a decrease
in inflammatory modulators and decreases in pain
scores. Gut biome can be enhanced by ingesting
fermented foods, pistachios, and resistant starches
such as raw potato starches, plantain flour, green
banana flour and cassava/tapioca starch.
Probiotic supplementation can also help support
intestinal immunity. Care should be given in
immunosuppressed or immunodepressed patients.
Probiotics that have been shown to reduce
visceral sensitivity and pain include Lactobacillus
farciminis, L paracasei NCC2461, B infantis 35624
and B lactis CNCM I-2494.
Aloe has been shown to have antiinflammatory, antimicrobial activity, and to
increase plasma total antioxidant capacity. Its
anti-inflammatory properties occur through a
bradykininase activity on vascular permeability.
Some studies have demonstrated a support in the
gut microbiome.
Quercitin is a bioflavinoid found in seeds,
citrus fruits, olive oil, tea and red wine. It exerts
an inhibitory effect on mast cells, preventing
histamine release. It has also shown to have antiinflammatory and antioxidant effects. Quercitin
was studied as a supplement for Interstitial Cystitis
patients and demonstrated a 57% decrease in
O’Leary Sant Symptom and Problem scores.
Glucosamine and chondroitin has antiinflammatory properties. Supplementation
with Cystoprotek (chondroitin, glucosamine,
hyaluronate, quercetin, rutin) demonstrated Visual
Analog Scores for pain to decrease by 43.552.1% with 6 to 12 month usage. Chondroitin
supplementation demonstrated a 36% lowering in
high sensitivity C Reactive Protein (hsCRP) levels
and 27% lowering of prostaglandins (PGE-M) over
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nonusers. Glucosamine use resulted in 28% lower
hsCRP and 24% lower PGE-M than nonusers.
Other studies have demonstrated that glucosamine
and chondroitin sulfate together have a synergistic
response.
Interstitial Cystitis and Complementary and
Alternative Medicine Therapies
Effect of time since diagnosis on perceived
effectiveness of CAM therapies
CAM therapy
Worked significantly better (p ≤ .05)
for those diagnosed early (n)
No significant improvement for those diagnosed
late (after 1 year and/or greater than 10 years) (n)
Limiting food or beverages that cause flares
or strict adherence to an IC diet list
<1 year ago (160) 26 %
>10 years ago (450) 74 %
Calcium glycerophosphate (Prelief)
<1 year ago (81) 8 %
1–5 years ago (362) 37 %
5–10 years ago (229) 23 %
>10 years ago (315) 32 %
Relaxation
<1 year ago (62) 20 %
>10 years ago (253) 80 %
Aloe Vera capsules or juice
<1 year ago (44) 12 %
5–10 years ago (127) 35 %
Yoga
<1 year ago (34) 18 %
>10 years ago (159) 82 %
Quercetin-containing supplement
(CystoProtek)
<1 year ago (30) 26 %
>10 years ago (86) 74 %
Glucosamine/chondroitin
<1 year ago (24) 13 %
>10 years ago (165) 87 %
>10 years ago (195) 53 %
Peter Gregory O’HareIII , Amy Rejba Hoffmann,
Penny Allen, Barbara Gordon, Linda Salin,
Kristene Whitmore, Interstitial cystitis patients’
use and rating of complementary and alternative
medicine therapies. International Urogynecology
Journal June 2013, Volume 24, Issue 6, pp 977-982
Conclusion
Interstitial Cystitis/Painful bladder syndrome
should be viewed as a chronic pain syndrome.
Early treatment is the key to success. Employing a
multimodal approach results in improved success
rates. First line therapies of education, exercise,
diet, and psychotherapy should be enacted as soon
as possible.
References:
1.
Almeida C1, DeMaman A, Kusuda R, Cadetti F, Ravanelli MI,
Queiroz AL, Sousa TA, Zanon S, Silveira LR, Lucas G. Exercise
therapy normalizes BDNF upregulation and glial hyperactivity in
a mouse model of neuropathic pain. Pain. 2015 Mar;156(3):50413. doi: 10.1097/01.j.pain.0000460339.23976.12.
2.
American Urologic Association Guidelines to Management of
Interstitial Cystitis https://www.auanet.org/education/guidelines/
ic-bladder-pain-syndrome.cfm
3.
Baerheim A, Digranes A, Hunskaar S. Evaluation of urine
sampling technique: bacterial contamination of samples from
women students. Br J Gen Pract 1992; 42:241.
4.
Bałan BJ1, Niemcewicz M2, Kocik J2, Jung L3, Skopińska-
(Continued on Page 13)
12
ACOOG
2015 WINTER EDITION
Cell-Free Fetal DNA Analysis and Its Use in Aneuploidy Screening
(Continued from Page 12)
10)
Różewska E4, Skopiński P5. Oral administration of Aloe
vera gel, anti-microbial and anti-inflammatory herbal remedy,
stimulates cell-mediated immunity and antibody production in
a mouse model. Cent Eur J Immunol. 2014;39(2):125-30. doi:
10.5114/ceji.2014.43711. Epub 2014 Jun 27.
5.
Bailey RR, Little PJ. Suprapubic bladder aspiration in diagnosis
of urinary tract infection. Br Med J 1969; 1:293.
6.
Bent S, Nallamothu BK, Simel DL, et al. Does this woman have
an acute uncomplicated urinary tract infection? JAMA 2002;
287:2701.
7.
Bland, J. (1985, March/April). The effect of orally consumed
Aloe vera juice on gastrointestinal function in normal humans.
Preventive Medicine
8.
9.
Bologna RA, Gomelsky A, Lukban JC, Tu LM, Holzberg AS,
Whitmore KE. The efficacy of calcium glycerophosphate in the
prevention of food-related flares in interstitial cystitis. Urology.
2001 Jun;57(6 Suppl 1):119-20.
Chiungjung Huang. Cyberpsychology, Behavior, and Social
14. Drummond, J Functional Nutrition for Chronic Pelvic
Pain:Evidence- Based Treatments for Success. International
Pelvic Pain Society Annual Conference 2015 San Diego
California
15. Eagan JW. Urinary tract cytology. In: Uropathology, Hill GS
(Ed), Churchill Livingstone, Philadelphia 1989. Vol 2, p.873.
16. Eigbefoh JO, Isabu P, Okpere E, Abebe J. The diagnostic
accuracy of the rapid dipstick test to predict asymptomatic
urinary tract infection of pregnancy.J Obstet Gynaecol. 2008
Jul;28(5):490-5. doi: 10.1080/01443610802196914
17. Eysenbach G, J Powell, M Englesakis, C Rizo, A Stern,Health
related virtual communities and electronic support groups:
systematic review of the effects of online peer to peer
interactions- Bmj, 2004 - bmj.com
18. Fasano A, Leaky gut and autoimmune diseases. Clin Rev Allergy
Immunol. 2012 Feb;42(1):71-8. doi: 10.1007/s12016-0118291-x.
Networking. June 2010, 13(3): 241-249. doi:10.1089/
cyber.2009.0217.
19. Feldman MD, Munchausen by Internet: detecting factitious
illness and crisis on the Internet.South Med J. 2000
Jul;93(7):669-72.
10. Czaja CA, Scholes D, Hooton TM, Stamm WE. Population-
20. Fenton BW, Limbic associated pelvic pain: a hypothesis to
based epidemiologic analysis of acute pyelonephritis. Clin Infect
Dis 2007; 45:273.
11. Czarapata, B. J. (1995, October). Super-Strength Aloe vera
capsules in interstitial cystitis, painful bladder syndrome, chronic
pelvic pain, and nonbacterial prostatitis: A double-blind, placebocontrolled crossover trial using Desert Harvest Aloe vera at the
Urology Wellness Center, Rockville, Maryland. Proceedings
of the NIDDK Scientific Symposium, San Diego, California.
National Institutes of Health, Rockville, Maryland.
12. Davis, R. H., Di Donato, J. J., Hartman, G. M., and Haas, R. C.
(1992). Mannose-6-phosphate: Anti-inflammatory and activity of
a growth substance in Aloe vera. Submitted for 1993 William J.
Stickle Award, http://www.desertharvest.com
13. Devillé WL, Yzermans JC, van Duijn NP, et al. The urine
dipstick test useful to rule out infections. A meta-analysis of the
accuracy. BMC Urol 2004; 4:4.
explain the diagnostic relationships and features of patients with
chronic pelvic pain. Med Hypotheses. 2007;69(2):282-6. Epub
2007 Feb 9.
21. Frazee BW1, Enriquez K1, Ng V2, Alter H1. Abnormal
urinalysis results are common, regardless of specimen
collection technique, in women without urinary tract infections.
J Emerg Med. 2015 Jun;48(6):706-11. doi: 10.1016/j.
jemermed.2015.02.020. Epub 2015 Apr
22. Friedlander J, Barbara Shorter2 andRobert M. Moldwin Diet and
its role in interstitial cystitis/bladder pain syndrome (IC/BPS)
and comorbid conditions U International Vol 109 Issue 11
23. Frosali S, Pagliari D, Gambassi 1, Landolfi R, Pandolfi 1,
Cianci R. How the Intricate Interaction among Toll-Like
Receptors, Microbiota, and Intestinal Immunity Can Influence
Gastrointestinal Pathology. J Immunol Res. 2015;2015:489821.
doi: 10.1155/2015/489821. Epub 2015 May 18.
(Continued on Page 14)
2015 WINTER EDITION
ACOOG
13
IInterstitial Cystitis: Current Recommendations with a Focus on First Line Therapy
(Continued from Page 13)
24. Giorgio F, Ierardi E, Di Leo A, Principi M. Non steroidal antiinflammatory drug induced damage on lower gastro-intestinal
tract: is there an involvement of microbiota? Curr Drug Saf.
2014;9(3):196-204.
25. Global Library of Women’s Medicine Castellanos, M, Desai, N,
et al, Glob. libr. women’s med.,
26. (ISSN: 1756-2228) 2012; DOI 10.3843/GLOWM.10471http://
www.glowm.com/section_view/heading/Interstitial%20
Cystitis%20&%20Bladder%20Pain%20Syndrome/item/725
27. Gupta K, Trautner B. In the clinic. Urinary tract infection. Ann
Intern Med 2012; 156:ITC3.
28. Gupta K, Hooton TM, Roberts PL, Stamm WE. Patient-initiated
treatment of uncomplicated recurrent urinary tract infections in
young women. Ann Intern Med 2001; 135:9.
29. Gupta K, Hooton TM, Roberts PL, Stamm WE. Short-course
nitrofurantoin for the treatment of acute uncomplicated cystitis in
women. Arch Intern Med 2007; 167:2207.
Res. 2015 Aug 15;228(2):203-8. d
35. Hoeger-Bement MK1, Sluka KA. Phosphorylation of CREB and
mechanical hyperalgesia is reversed by blockade of the cAMP
pathway in a time-dependent manner after repeated intramuscular
acid injections. J Neurosci. 2003 Jul 2;23(13):5437-45.
36. Hollon J, Puppa EL, Greenwald B,Goldberg E, Guerrerio A,
Fasano A. Effect of gliadin on permeability of intestinal biopsy
explants from celiac disease patients and patients with nonceliac gluten sensitivity. Nutrients. 2015 Feb 27;7(3):1565-76.
doi:10.3390/nu7031565.
37. Holzel,B.,et al. Mindfulness practice leads to increases in
regional brain gray matter density. Psychiatry Res 191(1):36-43.
doi: 0.1016/j/psychresns.2010.08/006
38. Hooton TM, Roberts PL, Cox ME, Stapleton AE. Voided
midstream urine culture and acute cystitis in premenopausal
women. N Engl J Med 2013; 369:1883.
39. Hooton TM. Clinical practice. Uncomplicated urinary tract
infection. N Engl J Med 2012; 366:1028
30. Gyllenhammer LE, Weigensberg MJ, Spruijt-Metz D, AllayeeH,
Goran MI, Davis JN. Modifying influence of dietary sugar in
the relationship betweencortisol and visceral adipose tissue in
minority youth.Obesity (Silver Spring). 2014 Feb;22(2):474-81.
doi:10.1002/oby.20594. Epub 2013 Sep 20.
40. Jamero D., PharmD, BCOP; Amne Borghol, PharmD; Nina Vo,
PharmD Candidate; Fadi Hawawini, DO The Emerging Role of
NMDA Antagonists in Pain Management U.S. Pharmacist http://
www.medscape.com/viewarticle/744071_4
31. Hellhammer J1, Hero T, Franz N, Contreras C, Schubert
M. Omega-3 fatty acids administered in phosphatidylserine
improved certain aspects of high chronic stress in men. Nutr Res.
2012 Apr;32(4):241-50. doi:10.1016/j.nutres.2012.03.003. Epub
2012 Apr 30.
41. Jensen KB1, Kosek E, Wicksell R, Kemani M, Olsson G, Merle
JV, Kadetoff D, Ingvar M., Cognitive Behavioral Therapy
increases pain-evoked activation of the prefrontal cortex in
patients with fibromyalgia, Pain. 2012 Jul;153(7):1495-503. doi:
10.1016/j.pain.2012.04.010. Epub 2012 May 20.
32. Herati AS, Shorter B, Srinivasan AK, Tai J, Seideman C,
Lesser M, Moldwin RM, Effects of foods and beverages
on the symptoms of chronic prostatitis/chronic pelvic pain
syndrome. Urology. 2013 Dec;82(6):1376-80. doi: 10.1016/j.
urology.2013.07.015. Epub 2013 Aug 23.
42. Kantor ED1, Lampe JW, Navarro SL, Song X, Milne GL,
White E. Associations between glucosamine and chondroitin
supplement use and biomarkers of systemic inflammation. J
Altern Complement Med. 2014 Jun;20(6):479-85. doi: 10.1089/
acm.2013.0323. Epub 2014 Apr 16.
33. Hessdoerfer E, Jundt K, Peschers U. Is a dipstick test sufficient
to exclude urinary tract infection in women with overactive
bladder? Int Urogynecol J 2011; 22:229.
43. KASS EH. Asymptomatic infections of the urinary tract. Trans
Assoc Am Physicians 1956; 69:56.
34. Hilimire MR, DeVylder JE, Forestell CA, Fermented foods,
neuroticism, and social anxiety: Aninteraction model. Psychiatry
44. Koeijers JJ, Kessels AG, Nys S, et al. Evaluation of the nitrite
and leukocyte esterase activity tests for the diagnosis of acute
symptomatic urinary tract infection in men. Clin Infect Dis 2007;
(Continued on Page 15)
14
ACOOG
2015 WINTER EDITION
IInterstitial Cystitis: Current Recommendations with a Focus on First Line Therapy
(Continued from Page 14)
45:894.
45. Komaroff AL. Acute dysuria in women. N Engl J Med 1984;
310:368
supplement on chronic pelvic pain syndrome (Category IIIA),
leucocytospermia and semen parameters. Andrologia. 2012
May;44 Suppl 1:672-8. doi: 10.1111/j.1439-0272.2011.01248.x.
Epub 2011 Nov 7.
46. Kunin CM, White LV, Hua TH. A reassessment of the importance
of “low-count” bacteriuria in young women with acute urinary
symptoms. Ann Intern Med 1993; 119:454.
55. May A., Chronic pain may change the structure of the brain.,
Pain. 2008 Jul;137(1):7-15. doi: 10.1016/j.pain.2008.02.034.
Epub 2008 Apr 14.
47. Kuyken,W.etal.,Effectiveness and cost-effectiveness of
mindfulness-based cognitive therapy compared with maintenance
antidepressant treatment in the prevention of depressive relapse
or recurrence: a randomized controlled trial. Lancet Medical
Journal,386(9988):63-73. DOI:h_p://dx.doi.org/10.1016/S01406736(14)62222-4
56. McDonald MI, Lam MH, Birch DF, et al. Ureaplasma
urealyticum in patients with acute symptoms of urinary tract
infection. J Urol 1982; 128:517
48. Lambert GP1, Boylan M, Laventure JP, Bull A, Lanspa S. Effect
of aspirin and ibuprofen on GI permeability during exercise. Int J
Sports Med. 2007 Sep;28(9):722-6. Epub 2007 Apr 13.
49. Lambert GP , Lang J, Bull A,Pfeifer PC, Eckerson J, Moore
G,Lanspa S, O’Brien J, Fluid restriction during running
increases GI permeability. Int J Sports Med. 2008Mar;29(3):1948. Epub 2007 Jul 5
57. McKinnell JA, Stollenwerk NS, Jung CW, Miller LG.
Nitrofurantoin compares favorably to recommended agents as
empirical treatment of uncomplicated urinary tract infections in a
decision and cost analysis. Mayo Clin Proc 2011; 86:480.
58. McNeeley SG, Baselski VS, Ryan GM. An evaluation of two
rapid bacteriuria screening procedures. Obstet Gynecol 1987;
69:550.
59. Meister L, Morley EJ, Scheer D, Sinert R. History and physical
examination plus laboratory testing for the diagnosis of adult
female urinary tract infection. Acad Emerg Med 2013; 20:631.
50. Le Leu RK, Winter JM, Christophersen CT1 Young
GP,Humphreys KJ, Hu Y, Gratz SW, Miller RB, Topping DL,
Bird AR, Conlon MA. Butyrylated starch intake can prevent red
meat-induced O6-methyl-2-deoxyguanosine adducts in human
rectal tissue: a randomized clinical trial., Br J Nutr. 2015 Jun
17:1-11
51. Lifshitz E, Kramer L. Outpatient urine culture: does collection
technique matter? Arch Intern Med 2000; 160:2537.
52. Little P, Turner S, Rumsby K, et al. Dipsticks and diagnostic
algorithms in urinary tract infection: development and validation,
randomised trial, economic analysis, observational cohort and
qualitative study. Health Technol Assess 2009; 13:iii.
53. Little P, Turner S, Rumsby K, et al. Validating the prediction
of lower urinary tract infection in primary care: sensitivity and
specificity of urinary dipsticks and clinical scores in women. Br J
Gen Pract 2010; 60:495.
54. Lombardo F, Fiducia M, Lunghi R, Marchetti L, Palumbo A,
Rizzo F,Koverech A, Lenzi A, Gandini L. Effects of a dietary
60. Michael H. Ossipov, Gregory O. Dussor, and Frank Porreca,
Central modulation of pain,J Clin Invest. 2010 Nov 1; 120(11):
3779–3787.Published online 2010 Nov 1. doi: 10.1172/
JCI43766 PMCID: PMC2964993
61. Milspaw, A.T., Training the Brain to Heal Painful Habits,
Presented at the International Pelvic Pain Society Annual
Conference 2015, San Diego California
62. Milo G, Eugene Katchman, Mical Paul Thierry Christiaens,
Anders Baerheim4 Leonard Leibovic5 Editorial Group:
Cochrane Kidney and Transplant Group Duration of
antibacterial treatment for uncomplicated urinary tract infection
in women,Published Online: 20 APR 2005 Assessed as upto-date: 21 FEB 2005 DOI: 10.1002/14651858.CD004682.
pub2Copyright © 2010 The Cochrane Collaboration
63. Moghadamnia AA1, Mirhosseini N, Abadi MH, Omranirad A,
Omidvar S. Effect of Clupeonella grimmi (anchovy/kilka) fish oil
on dysmenorrhoea East Mediterr Health J. 2010 Apr;16(4):40813.
(Continued on Page 16)
2015 WINTER EDITION
ACOOG
15
IInterstitial Cystitis: Current Recommendations with a Focus on First Line Therapy
(Continued from Page 15)
64. National Institute of Diabetes, and Digestive and Kidney Health
ttp://www.niddk.nih.gov/health-information/health-topics/
urologic-disease/interstitial-cystitis-painful-bladder-syndrome/
Pages/facts.aspx
65. Pfaller MA, Koontz FP. Laboratory evaluation of leukocyte
esterase and nitrite tests for the detection of bacteriuria. J Clin
Microbiol 1985; 21:840.
66. Plaskett, L. G. (1996, May). Aloe vera eases inflammation. Aloe
Vera Information Services (newsletter). Camelford, Cornwall,
UK: Biomedical Information Services Ltd.
67. Platt R. Quantitative definition of bacteriuria. Am J Med 1983;
75:44.
68. Pollock HM. Laboratory techniques for detection of urinary tract
infection and assessment of value. Am J Med 1983; 75:79.
69. Prueksrisakul T, Chantarangsu S, Thunyakitpisal P. Effect
of daily drinking of Aloe vera gel extract on plasma total
antioxidant capacity and oral pathogenic bacteria in healthy
volunteer: a short-term study. J Complement Integr Med. 2015
Jun 1;12(2):159-64. doi: 10.1515/jcim-2014-0060.
heat-stressed growing pigs Animal. 2014 Jan;8(1):43-50. doi:
10.1017/S1751731113001961. Epub 2013 Nov 7.
75. Sarkar, D., Dutta, A., Das, M., Sarkar K., Mandal, C., and
Chatterjee, M. (2005, November 1). Effect of Aloe vera on nitric
oxide production by macrophages during inflammation. Indian
Journal of Pharmacology.
76. Schneeberger C, van den Heuvel ER, Erwich JJ, et al.
Contamination rates of three urine-sampling methods to assess
bacteriuria in pregnant women. Obstet Gynecol 2013; 121:299
77. Schrepf A, Bradley CS, O’Donnell M, Luo Y, Harte SE, Kreder
K, Lutgendorf S; Toll-like Receptor 4 and comorbid pain in
Interstitial Cystitis/Bladder Pain Syndrome: A Multidisciplinary
Approach to the Study of Chronic Pelvic Pain research
network study. Brain Behav Immun. 2015 Mar 11. pii: S08891591(15)00074-4. doi: 10.1016/j.bbi.2015.03.003
78. Schwertner A1, Conceição Dos Santos CC, Costa GD, Deitos A,
de SouzaA, de Souza IC, Torres IL, da Cunha Filho JS, Caumo
W. Efficacy of melatonin in the treatment of endometriosis: a
phase II,randomized, double-blind, placebo-controlled trial. Pain.
2013 Jun;154(6):874-81. doi: 10.1016/j.pain.2013.02.025. Epub
2013
70. Rahbar N, Asgharzadeh N, Ghorbani R. Effect of omega-3 fatty
acids on intensity of primary dysmenorrhea. Int J Gynaecol
Obstet. 2012 Apr;117(1):45-7. doi:10.1016/j.ijgo.2011.11.019.
Epub 2012 Jan 17.
71. Sahinkanat T1, Ozturk E, Ozkan Y, Coskun A, Ekerbicer H.
The relationship between serum testosterone levels andbladder
storage symptoms in a female population with polycystic ovary
syndrome.Arch Gynecol Obstet. 2011 Oct;284(4):879-84.
doi:10.1007/s00404-010-1767-8. Epub 2010 Nov 25.
72. SANFORD JP, FAVOUR CB, MAO FH, HARRISON JH.
Evaluation of the positive urine culture; an approach to the
differentiation of significant bacteria from contaminants. Am J
Med 1956; 20:88.
73. Santarnecchi, E., et al.Interaction between neuroanatomical and
psychological changes and mindfulness based training. PLoS
One,9(10):e108359.doi:10.1371/journal.pone.0108359
74. Sanz Fernandez MV, Pearce SC, Gabler NK, Patience JF, Wilson
ME, Socha MT,Torrison JL, hoads RP, Baumgard LH, Effects
of supplemental zinc amino acid complex on gut integrity in
79. Seminowicz DA1, Shpaner M, Keaser ML, Krauthamer GM,
Mantegna J, Dumas JA, Newhouse PA, Filippi CG, Keefe FJ,
Naylor MR., Cognitive-behavioral therapy increases prefrontal
cortex gray matter in patients with chronic pain., J Pain. 2013
Dec;14(12):1573-84. doi: 10.1016/j.jpain.2013.07.020. Epub
2013 Oct 14.
80. Shorter B, Lesser M, Moldwin RM, Kushner L. Effect of
comestibles on symptoms of interstitial cystitis.Urol. 2007
Jul;178(1):145-52. Epub 2007 May 11.
81. Simis MReidler JS, Duarte Macea D, Moreno Duarte , Wang
4, Lenkinski R, Petrozza JC, Fregni F, Investigation of central
nervous system dysfunction in chronic pelvic pain using
magnetic resonance spectroscopy and noninvasive brain
stimulation. Pain Pract. 2015 Jun;15(5):423-32. doi: 10.1111/
papr.12202. Epub 2014 May 2.
82. Sluka, K. A. , Normal Sedentary Exercise,\:MODELS OF
MUSCLE PAIN:TRANSMITTING THE MESSAGE, Presented
at the International Pelvic Pain Society Annual Conference 2015,
San Diego California
(Continued on Page 17)
16
ACOOG
2015 WINTER EDITION
IInterstitial Cystitis: Current Recommendations with a Focus on First Line Therapy
(Continued from Page 16)
83. Stamm WE. Measurement of pyuria and its relation to
bacteriuria. Am J Med 1983; 75:53.
84. Stamm WE, Wagner KF, Amsel R, et al. Causes of the acute
urethral syndrome in women. N Engl J Med 1980; 303:409.
85. Stamm WE, Counts GW, Running KR, et al. Diagnosis of
coliform infection in acutely dysuric women. N Engl J Med
1982; 307:463.
86. St John A, Boyd JC, Lowes AJ, Price CP. The use of urinary
dipstick tests to exclude urinary tract infection: a systematic
review of the literature. Am J Clin Pathol 2006; 126:428.
87. Tapsall JW, Taylor PC, Bell SM, Smith DD. Relevance of
“significant bacteriuria” to aetiology and diagnosis of urinarytract infection. Lancet 1975; 2:637.
composition in a randomized cross-overhuman feeding
study.Br J Nutr. 2014 Jun 28;111(12):2146-52. doi:10.1017/
S0007114514000385. Epub 2014 Mar 18.
95. Webster DC, Brennan T., Self-care strategies used for acute
attack of interstitial cystitis. Urol Nurs. 1995 Sep;15(3):86-93.
96. Webster DC, Brennan T., Use and effectiveness of psychological
self-care strategies for interstitial cystitis. Health Care
Women Int. 1995 Sep-Oct;16(5):463-75.oi:10.1016/j.
psychres.2015.04.023. Epub 2015 Apr 28.
97. Whitmore KE, Complementary and Alternative Therapies as
Treatment Approaches for Interstitial Cystitis Rev Urol. 2002;
4(Suppl 1): S28–S35. PMCID: PMC1476005
98. Williams GJ, Macaskill P, Chan SF, et al. Absolute and relative
accuracy of rapid urine tests for urinary tract infection in
children: a meta-analysis. Lancet Infect Dis 2010; 10:240.
88. Theoharides TC1, Kempuraj D, Vakali S, Sant GR. Treatment
of refractory interstitial cystitis/painful bladder syndrome with
CystoProtek--an oral multi-agent natural supplement. Can J Urol.
2008 Dec;15(6):4410-4.
99. Wilson ML, Gaido L. Laboratory diagnosis of urinary tract
infections in adult patients. Clin Infect Dis 2004; 38:1150.
89. Theodorou V, Ait Belgnaoui A, Agostini S, Eutamene H, Effect
100. Zalmanovici Trestioreanu A,, Hefziba Green, Mical Paul,
of commensals and probiotics on visceral sensitivity and
pain in irritable bowel syndrome. Gut Microbes. 2014 MayJun;5(3):430-6. doi: 10.4161/gmic.29796.
90. Tokuyama S1, Nakamoto K. Unsaturated fatty acids and pain.
Biol Pharm Bull. 2011;34(8):1174-8.
John Yaphe, Leonard Leibovici Editorial Group: Cochrane
Kidney and Transplant Group,Antimicrobial agents for treating
uncomplicated urinary tract infection in women,Published
Online: 6 OCT 2010Assessed as up-to-date: 15 FEB 2010 DOI:
10.1002/14651858.CD007182.pub2
91. Tosi , Negri C, Perrone F, Dorizzi R, Castello R, Bonora E,
Moghetti P.Hyperinsulinemia amplifies GnRH agonist stimulated
ovarian steroid secretion in women with polycystic ovary
syndrome. J Clin Endocrinol Metab. 2012 May;97(5):1712-9.
doi: 10.1210/jc.2011-2939. Epub 2012 Mar 14
Training your brain to adopt
92. Tranon,J. etal.(2011).
healthful habits: Mastering the fivebrain challenges.
LosAltos,CA: Institute for DiseaseManagement.
93. Turner LC1, Beigi R, Shepherd JP, Lowder JL. Utility of dipstick
urinalysis in peri- and postmenopausal women with irritative
bladder symptoms. Int Urogynecol J. 2014 Apr;25(4):493-7. doi:
10.1007/s00192-013-2247-z. Epub 2013 Oct 30.
94. Ukhanova M, Wang X, Baer DJ, Novotny JA,Fredborg M, Mai V
. Effects of almond and pistachio consumption on gut microbiota
2015 WINTER EDITION
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17
Highlights
2015 Fall Conference
October 21-25, 2015
Loews Portofino Bay Hotel Universal Studios - Orlando, Fl
Eric J. Carlson, DO presents the ACOOG Mentor of the
Year Award to Tanya Taival, DO.
Eric Carlson DO, presents ACOOG Services to the Board of
Trustees 2012-2015 Award to Glenn Bigsby IV, DO.
18
ACOOG
2015 WINTER EDITION
Michael J. Geria, DO presnts the ACOOG Past President
Honorary Lecture to David Wolf, DO, FACOOG (Dist).
Eric J. Carlson, DO presents the ACOOG Lifetime Service
Award to Steve P Buchanan, DO, FACOOG (Dist).
ACOOG Membership News
New Members
Welcome new members! The Board of Trustees approved the following new
members at the October 2015 meeting in Orlando, Fl.
New Regular Members
Sushma Anand, DO
Lauren Britt, DO
Michelle Brunnabend, DO
Denise Carnegie, DO
Sandy Cho, DO
Christine Cortadillo, DO, FACOOG
Meghan Cox-Pedota, DO
Neely Elisha, DO
Alma Farin, DO
Michele Finkle, DO
Raechel Fockler, DO
Jennifer Gilbert, DO, FACOOG
Christina Gomez, DO
Danielle Hay, DO
Amy Hertweck-Warner, DO, FACOOG
Timothy Hutchings, DO, FACOOG
Renee Hypolite, DO
Shireen Jayne, DO, FACOOG
Kendra Johnson, DO
Kathryn Jones, DO
Rachel Kaplan, DO
Brad Kasavana, DO
Jun Kim, DO
Jenna Kolodziej, DO
Ashley Lane,DO
Karen Lee, DO
Thuy Mai, DO
Khristin McAfee, DO
Sarah McCormick, DO
Hodon Mohamed, DO
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Rochelle Orr, DO
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Camille Semple, DO, FACOOG
Rajasree Seshadri, DO
Vasiliy Stankovich, DO, FACOOG
Christopher Strauchon, DO, FACOOG
Melissa Suarez, DO
Kristen Terranova, DO
Amanda Walker, DO
Lindsay Wardle, DO
Steven Wenrich, DO, FACOOG
Amy Willcox, DO
Amy Zafarani, DO
Life Membership Applications
Emil Felski, DO, FACOOG
Ray Greco, DO
Valerie Payne-Jackson, DO, FACOOG
William Tindall, DO, FACOOG
Affiliate Membership Applications
James Aikins, MD
Salil Khandwala, MD
2015 WINTER EDITION
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19
ACOOG Calendar of Events
Neonatal Counseling
(Continued from Page 16)
& AOBOG News
ACOOG CME
Calendar of Events
84th Annual Conference
March 26-31, 2017
JW Marriott Desert Springs
Palm Springs, CA
83rd Annual Conference
April 10-15, 2016
Marriott Harbor Beach
Fort Lauderdale, FL
2017 Fall Conference
October 7-11, 2017
Philadelphia, PA
Renaissance Cleveland
2016 Fall Conference
October 5-9, 2016
Renaissance Cleveland
Cleveland, OH
85th Annual Conference
April 8-13, 2018
Waldorf Astoria Bonnet Creek
Orlando, FL
(Continued on Page 21)
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ACOOG
2015 WINTER EDITION
Calendar of Events . . .
(Continued from Page 20)
AOBOG News
OCC is Here!
DOs holding time-limited certificates are required
to participate in OCC. Here are some important
tips for successfully completing OCC:
•
Your Practice Performance Assessment (PPA)
Modules are due on September 15th of the year
your current certificate expires.
•
The “Fundamentals of Effective
Communication” Module is required as one of
your PPAs for your first OCC cycle.
•
There are links to the PPA module vendor
(O-CAT) from both the AOBOG And ACOOG
websites. PPAs are being updated and new
PPAs are being added, so be sure to check back
often for updates!
•
You will receive specialty CME for each PPA
module you successfully complete.
•
OCC participation remains optional for
diplomates with non-time-limited certificates,
but is highly recommended and encouraged.
Learn more about what the requirements are
and register for OCC on the AOBOG website
(www.aobog.org/pages/occ_faqs).
Certification Opportunity for FPMRS
Physicians
Do you practice Female Pelvic Medicine and
Reconstructive Surgery (FPMRS)? The AOBOG
offers a Subspecialty Certificate in FPMRS. This
exam is still in its clinical pathway, which means
even if you did not participate in an FPMRS
fellowship, but at least 75% of your clinical
practice is devoted to FPMRS care, you could
qualify to sit for the exam. The clinical pathway is
only open until December 31, 2016, so don’t miss
out on this great opportunity to further your career
by becoming certified in FPMRS. (Please visit
www.aobog.org/documents for more information
and to see if you qualify.)
Become an AOBOG Examiner!
The AOBOG continues to recruit certified
generalists (actively practicing both OB and
GYN), and subspecialist OB/GYN physicians to
participate in Board activities, which include test
development and the administration of oral exams.
The Board and examiners meet twice a year for
exams, with training provided to new examiners.
Show yourself as a “cut above” by committing to
the future of osteopathic OB/GYN – you’ll earn
CME, contribute to your own lifelong learning, and
become part of a great group of OB/GYN leaders!
For more information or to apply, please visit the
AOBOG website or email the AOBOG at [email protected]
aobog.org.
The AOBOG would like to extend a warm
welcome to its newest examiners: Gus Barkett,
DO; Jessica Berg, DO; Angela Fleming, DO;
Aabeen Hagroo, DO; Kevin Hess, DO; Chadwick
Leo, DO; Sadaf Lodhi, DO; K. Daniel Miller,
DO; Sara Schallmo, DO; George Stefenelli, DO;
Takeko Takeshige, DO; and Bradley Stetzer, DO
(MFM).
2016 Examination Schedule
All examination applications are exclusively
available on the AOBOG website. View the
entire calendar of upcoming exams in 2016 at
www.aobog.org/pages/calendar. IMPORTANT
REMINDER: The Ob/Gyn OCC Exam is currently
offered only once per year!
Visit the AOBOG website (www.aobog.org)
for up-to-date information about certification,
examinations, applications and Osteopathic
Continuous Certification (OCC).
2015 WINTER EDITION
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Practice Opportunities
Seeking Full-Time BC/BE Laborist in Fabulous Las
Vegas, NV
Women’s Health Associates of Southern Nevada is an
OB/GYN specialty practice dedicated to delivering
innovative, compassionate care for women and their
families. WHASN comprises 18 care center locations
in the greater Las Vegas area and 39 board-certified or
board-eligible physicians. WHASN manages the laborist
programs at four major hospitals in the city.
Full-time employment would include 16 12-hour shifts
per month. The perfect candidate would be motivated,
energetic, and have at least 2-3 years of experience in
general OB/GYN.
Duties will include:
• Evaluating and managing triage patients in labor
and delivery
• Performing vaginal deliveries and C-sections
• Assisting with C-sections
• Evaluating ER patients
• Collaborating with labor and delivery nurses and
private physicians for the care of patients
We offer:
• Relocation expenses
• Pension benefits
• Medical, dental and vision healthcare coverage
About Las Vegas
• No income tax and low cost of living
• Family-friendly and diverse community
• Adjacent to Lake Mead, Red Rock National Park,
Mount Charleston, Hoover Dam, and Grand Canyon
• Easy access to world-class dining, shopping, golf
courses and entertainment
• Year-long warm weather with an average of 300
sunny days a year
• Short drive to McCarran International Airport from
any part of the city
• Growing healthcare destination
• Culture and activities beyond The Las Vegas
Strip – The Smith Center for the Performing Arts,
Nevada Ballet Theatre, The Springs Preserve, The
Children’s Discovery Museum, Wet ‘n’ Wild water
park, The Mob Museum, Las Vegas Natural History
Museum
Contact Information
Donna Miller, MD, FACOG
Email: [email protected]
Phone: (702) 577-1781
Women’s Health at Arrowhead Regional Medical
Center
The Department of Women’s Health at Arrowhead
Regional Medical Center (ARMC) is seeking a
Maternal-Fetal Medicine (MFM) Fellow. The
educational program is a 36 month progressive course
of specialty training designed to prepare osteopathic
Obstetrician-Gynecologists as specialists in MFM,
through didactic training, hands-on research, and
extensive clinical activity.
ARMC is located in the heart of San Bernardino
County, in beautiful Southern California. It’s only a
short drive to the scenic mountain recreational areas
of Lake Arrowhead and Big Bear, or to the beaches of
the sunny SoCal coast, or to the spas or golf courses
of Palm Springs. ARMC is a state of the art 456 bed
facility, trauma center, with a 30 bed level II NICU,
and is a Baby-Friendly designated hospital. It is also
home to a residency training program for 16 Ob/Gyn
residents. There are currently 4 staff perinatologists, 2
fellows, 1 geneticist, a genetics counsellor and research
assistant in the Division of MFM at ARMC, and 9 staff
perinatologists at the Rady Children’s Hospital / Sharp
Mary Birch site.
For more information contact Kristy Roloff, DO MPH
at [email protected], call Madeleine Collado
(fellowship coordinator) at (909)580-3496, or visit
OBGynDO.com to download an application.
(Continued on Page 23)
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ACOOG
2015 WINTER EDITION
Practice Opportunities . . .
(Continued from Page 22)
Assistant Professor and Chair of Obstetrics and
Gynecology College of Osteopathic Medicine
Marian University College of Osteopathic Medicine
(MU-COM) seeks an Assistant/Associate Professor of
Obstetrics and Gynecology and Chair of the Department
of OB/GYN. Reporting to the Chair of Clerkship
Education, this position contributes to the education
of pre-doctoral osteopathic medical students at Marian
University.
Ideal candidates must have knowledge of and
commitment to the mission of Marian University. The
successful candidate must be a DO or an MD and have
or be eligible for an unrestricted license to practice
in Indiana. The candidate must be certified by the
AOA or ABMS in OB/GYN. There must be a strong
background in medical education, with an interest in
teaching, scholarship and service.
The Assistant Professor will:
• Prepare and give lectures in large and small groups.
• Design and implement student assessments in
written, oral and skills testing format, including
patient history and physical examination
• Provide competency based evaluations and
remediations
• Design and implement clerkship experiences in
OB/GYN to include creating syllabus, providing
on-line instruction of commonly seen condition in
OB/GYN, creating competency requirements for
procedures, supervising volunteer OB/GYN faculty
preceptors, and designing continuous improvement
activities using student, preceptor, and facility
assessment instruments
• Provide leadership in student advisement,
administrative duties, and scholarly activities
Other duties as assigned.
• As Department Chair of OB/GYN, the Assistant
Professor also will:
• - Oversee volunteer clinical faculty preceptors in
MU-COM clerkships in OB/GYN;
• - Create and revise as needed OB/GYN clerkship
syllabi for presentation to the Curriculum
Committee;
• - Design a continuous quality improvement plan for
assessment and improvement of OB/GYN clerkship
experiences;
•
- Assist in faculty development for OB/GYN
clinical faculty; and
• - Encourage and support scholarly activity on the
part of OB/GYN clinical faculty.
Located within 10 minutes of downtown Indianapolis,
Marian University is one of the nation’s preeminent
Catholic institutions of higher learning, and ranks
in the Top 25 of US News & World Report’s list of
Midwest Region colleges, as well as Money magazine’s
list of Top 10 schools in Indiana “For Your Money”.
Marian University was founded in 1937 by the Sisters
of St. Francis, Oldenburg, Indiana, and the Franciscan
Values that the Sisters ingrained into the university’s
culture are still prevalent today. The university has
experienced tremendous growth in the past 10 years
under the leadership of President Daniel J. Elsener,
including the opening of the Marian University College
of Osteopathic Medicine in 2013 – the state’s first
new medical school in 110 years. In 2012, Marian
University’s football team captured the NAIA national
championship in just its sixth year of existence. Marian
University is also home to the most successful collegiate
cycling program in the nation, which currently holds 30
national titles.
For best consideration, submit a CV with a statement
of teaching philosophy and research interest as well
as three (3) professional references to [email protected]
Applications will be received until the position has been
filled.
Marian University is An Equal Opportunity Employer
GENERAL OBSTETRICIAN/GYNECOLOGIST
Immediate opening for 2 BC/BE OB/GYN physicians
to join growing private practice in thriving, family
friendly, health minded Orlando, FL suburb. Twenty
minutes from downtown, 1 hour to beach, and close to
all area attractions. Abundant, affordable lakefront real
estate, and 300+ days of sunshine per year. 1:4 call with
no ER/walk in coverage duties. Hospital has 24/7 OB
hospitalist program who sees all triage patients. Office is
located within community hospital which is state of the
art, with new Da Vinci Xi robot. Two year competitive
income guarantee.
For more information contact Nicole at 352-241-7050 or
submit your CV to [email protected]
(Continued on Page 24)
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Practice Opportunities . . .
(Continued from Page 23)
FELLOWSHIP in FPMRS
Advanced Urogynecology of Michigan P.C. along with
Beaumont Health is now a fully accredited site for
Female Pelvic Medicine and Reconstructive Surgery
fellowship by the ACOOG/AOA. This is a 3-year
fellowship program.
Dr. Salil Khandwala is the fellowship director and the
director of Urogynecology and FPMRS at Beaumont
Health - Oakwood Campus. Dr. Khandwala has
extensive experience in the field of FPMRS and was part
of the first group to be board certified in this field. Dr.
Khandwala is part of the UITN (Urinary Incontinence
Treatment Network) and also the PFDN (Pelvic Floor
Disorders Network), both under the auspices of the NIH.
The fellowship allows extensive clinical, research
and teaching opportunities. Our program provides
comprehensive exposure to urogynecologic issues,
colorectal issues and pertinent urology issues with the
focus being on innovation and outcomes improvement.
You will be provided with a full range of educational
opportunities involving the bladder (incontinence, pain,
and fistula), vagina (prolapse, pain), and bowel (fecal
incontinence, constipation, and IBS).
Additional faculty members are Dr. Craig Glines
(osteopathic education), Dr. Richard Sarle (urology) and
Dr. Ganesh Deshmukh (colorectal).
Program inquiries should be directed to Ms. Amanda
Henry at [email protected] (preferable) or contact us
at 313-982-0200. Please also visit our website at www.
augm.org
MATERNAL FETAL MEDICINE FELLOWSHIP
PinnacleHealth Maternal Fetal Medicine is currently
accepting applications for a Maternal Fetal Medicine
Fellowship position at Pinnacle Health Harrisburg
Hospital, PA, sponsored through LECOM and Pinnacle
Health System for the July 2017 start date. Francis J.
Martinez, DO, FACOOG is our Fellowship Program
Director. The program is 36-month fellowship training
in maternal and fetal medicine approved by the
American Osteopathic Association and the American
College of Osteopathic Obstetricians and Gynecologists.
It is designed to provide the osteopathic fellow
with advanced and concentrated training and board
preparation in maternal and fetal medicine. To assure the
quality training for each fellow, the program is designed
to train three (3) fellows or less at any given time.
Harrisburg Hospital is a 640-bed hospital and part of the
Pinnacle Health System and performs approximately
5,000 deliveries annually. The fellowship education is
provided by dedicated and experienced faculty. Please
contact Patricia Suhr, Program Coordinator at [email protected]
pinnaclehealth.org, ww.mfmcp.com, 717-231-8640 or
Patricia Suhr, PinnacleHealth Maternal Fetal Medicine,
100 S. Second Street, Suite 4B, Harrisburg, PA, 17101.
MFM-Fellowship LECOM
Wellspan Health/Lake Erie College of Osteopathic
Medicine are proud to announce the availability of a
first year fellowship opening in Maternal-Fetal Medicine
at York Hospital with a position start date of July
1st, 2017. Our fellowship program is an affiliation of
Lake Erie College of Osteopathic medicine and York
Hospital/Wellspan Health, and is accredited through the
American Osteopathic Association. It is a three-year
program involving direct patient care and a combination
of didactic education and clinical research leading to
board eligibility in Maternal-Fetal Medicine. Each
program year is currently filled, and this is the next
available slot.
Our program includes complete maternal and fetal risk
assessment and management of pre-conceptual, prenatal,
intrapartum, and postpartum complications. We provide
a full range of fetal diagnostic ultrasound and antenatal
testing, with accreditation through the AIUM. The
fetal echocardiography lab is directed by MFM and is
independently accredited through the ICAEL. Invasive
maternal and fetal diagnostic and therapeutic procedures
include amniocentesis, CVS, fetal vesicocentesis/
thoracentesis, cordocentesis, and fetal transfusion
medicine. Surgical training in the placement of both
elective and emergent/rescue cerclage and prophylactic
cervico-isthmic permanent cerclage is included in the
(Continued on Page 25)
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ACOOG
2015 WINTER EDITION
Practice Opportunities . . .
(Continued from Page 24)
2015 FALL CONFERENCE
October 21-25, 2015
Residency Program Director Opportunity
LoewsOB/GYN
Portofino
Bay Hotel at
in Tampa, FL Area
program. The perinatal center staff includes five MFM
physicians, certified perinatal sonographers, genetic
counselors, a perinatal nurse practitioner, and antenatal
testing staff.
Maternal high-risk transports are via ambulance
and helicopter and we are a regional center for the
management of diabetes in pregnancy. Rotations are
scheduled in the second and third years at the Fetal
Diagnosis and Therapy Center at the Children’s Hospital
of Philadelphia, as well as Medical Genetics.
York Hospital is a 558 bed institution located in
York, PA and is the largest obstetrical care provider in
south central Pennsylvania with approximately 3400
deliveries; it is the main teaching hospital and trauma
center for our region. The NICU has 38 bassinets and
24-hour coverage by 6 full time neonatologists, as well
as neonatal nurse practitioners. Full time research
support is available at the main campus through the
Emig Research Center.
Program inquiries and requests for applications can
be sent to Tina DeBlick, 717-812-3074 or [email protected]
wellspan.org More information regarding our program,
York Hospital, and Southcentral Pennsylvania is
available via our medical education website: http://
www.yorkhospital.edu/. Questions regarding the
program can be directed to Tina DeBlick or the MFM
Program Director, James Hole, DO, 717-851-2722.
Brandon Regional Hospital, Brandon, FL
Universal
Studios
Job Summary
HCA West Florida is seeking an OB/GYN Program
Director to lead Brandon Regional Hospital in the
development and implementation of a new OB/GYN
Residency Program. Anticipated start of the program
is July 2017. This is an exciting opportunity for an
experienced, motivated leader to have input on building
a multi-site program from the ground up. Brandon
Regional Hospital is located in Brandon, Florida and is
part of the greater Tampa Bay area.
Orlando, FL
Qualifications:
• Must hold a current certification in the specialty by the
American Board of Obstetrics and Gynecology (ABOG)
• Requisite specialty expertise and documented
educational and administrative experience acceptable to
the RRC
• Willing to combine Administrative and Diagnostic
(teaching) Responsibilities
• Must be able to obtain a Florida Medical License and
appropriate medical staff appointment
• Have strong administrative and team building skills
• Excellent interpersonal and communication skills
• Must have a minimum of 5 years clinical experience
in Obstetrics and Gynecology after completion of a
residency in the specialty
Candidates with recent scholarly activity such as peer
reviewed funding, publication of original research or
review articles in peer-reviewed journals, chapters in
textbooks, publication or presentation of case reports
or clinical series at scientific society meetings, or
participation in national committees or educations
organizations highly encouraged to apply.
Contact Information:
Email: [email protected]
Recruiting ads can be submitted to ACOOG
by fax 817-377-0439, mail at 8851 Camp Bowie West, Suite 275,
Fort Worth, TX 76116 or by email to
[email protected]
Subject: Opportunity Ad
2015 WINTER EDITION
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ACOOG 83rd Annual Conference
William Ashley Hood, DO
Program Chair
April 10-15, 2016
Marriott Harbor Beach
Fort Lauderdale, FL
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Eav Lim, DO
Program Chair
83rd Annual Conference
WELCOME & CONFERENCE OVERVIEW
It is our pleasure to invite you to the 83rd Annual Conference of
the American College of Osteopathic Obstetricians and
Gynecologists. This conference has been carefully designed to
meet the unique educational needs of ACOOG members, offering thorough scientific assessment of a variety of clinical topics
and controversial issues that OB/GYNs face today. In addition
to cutting-edge presentations, this year’s schedule provides an
opportunity to participate in four breakout sessions. We hope
you will register for the 83rd Annual Conference.
Thank you for supporting ACOOG through your membership.
LOCATION & LODGING
Fort Lauderdale Marriott Harbor Beach Resort & Spa
3030 Holiday Drive
Fort Lauderdale, FL 33316
Group ID: ACOOG
Reflect and reconnect when you experience Fort Lauderdale Marriott
Harbor Beach Resort & Spa. Highlighted by a pristine, oceanfront location
and close proximity to the airport, our luxury Fort Lauderdale beach resort
in an ideal getaway from the pressures of life. Enjoy an idyllic private
beach with 16 waterfront acres, located near the area’s most popular
attractions. Our 22,000-square-foot spa offers a variety of relaxing
treatment, a private spa pool and fitness canter with ocean views. Three
restaurants span our resort, including the upscale 3030 Ocean Restaurant
with modern American seafood. Dive into our tropical lagoon pool, sip
a cocktail under swaying palms tress, or make memories with a variety of
water sports and children’s activities at our Fort Lauderdale beach hotel.
Over 100,000 total square feet of event space for spectacular meeting and
celebrations. Sea Yourself at Harbor Beach!
ACOOG Rate $249.00
2015 WINTER EDITION
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CREDIT STATEMENTS
Learning Objectives
The American College of Osteopathic Obstetricians & Gynecologists
has requested that the AOA Council
on Continuing Medical Education approve this program for 30
credits of AOA Category 1A CME.
Physicians should only claim credit
commensurate with the extent of
their participation in the activity.
A completed attestation form and
post-course evaluation are required
to receive CME credit and a certificate of attendance.
Those participating in this activity will
receive information that should allow
them to...
•
Enhance the skills needed to diagnose and manage common and
uncommon clinical challenges faced
in a modern OB/GYN practice.
•
Address current and future OB/GYN
practice issues.
•
Apply advances in technology and
therapeutics to facilitate improved
patient care and outcomes.
Photography Disclaimer
ACCREDITATION
The American College of Osteopathic Obstetricians &
Gynecologists is accredited by the American Osteopathic
Association to award continuing medical education to
physicians. This activity has been planned and implemented
in accordance with the Policies of the Council on Continuing
Medical Education of the American Osteopathic Association.
Registration and attendance at, or
participation in ACOOG meetings
and other non-CME activities constitutes an agreement by the registrant
to ACOOG’s use and distribution of
the registrant’s or attendee’s image
or voice in photographs, videotapes,
electronic reproductions and
audiotapes of such activity.
PRINTED SYLLABUS
In continued effort to go green, there will not
be a printed syllabus. However, if you would
like to order a printed copy of the syllabus
make sure to indicate on the registration form.
The cost is $45 and must be pre-ordered with
your registration. Printed copies will NOT be
available on site. Check the ACOOG website
one week prior to the conference to download
the syllabus.
PRESIDENTS CELEBRATION
More information will be provided as we
get closer to the event.
Thank youi!
Preliminary 83rd Annual Conference
SUNDAY (April 10, 2016)
8:00 AM-12:00 PM ACOOG Board of Trustees meeting
12:00 - 5:00 PM EARLY REGISTRATION
Subspecialty Pre-Course - REI
3:00-3:50
New Advances in IVF
Dana Ambler, DO
Jenna McCarthy, MD
3:50-4:40
Ectopic Pregnancy
1:50-2:40Obesity and Reproduction
Enrique Soto, MD
1:00-1:50 PM
Fibroids and Infertility
Jennifer Nichols, DO
2:40-3:00Break
4:40-5:00 PM
MONDAY (April 11, 2016)
6:30-7:30 AM
Resident Reporter Orientation Breakfast
7:45-8:30
TUESDAY (April 12, 2016)
David Roy, DO
7:00-7:30 REGISTRATION/BREAKFAST/EXHIBITORS
Presidential Welcome
7:30-8:15
Outcomes, Outcomes, Outcomes
Surviving the Threat of Burnout
Miguel Fernandez, DO
6:30-7:30REGISTRATION/BREAKFAST/EXHIBITORS
7:30-7:45
Question and Answer Aession
Gail Goldsmith Memorial Lecture
8:15-9:00
Roger Smith, MD
Cesarean Delivery - Best Practices
9:00-9:45
Thomas Dardarian, DO
William Bradford, DO
Wound Care Management in the Obese Patient
9:45-10:15 BREAK WITH EXHIBITORS
David Jaspan, DO
10:15-11:00 The Wellness Exam
10:00-10:45 BREAK WITH EXHIBITORS
Alexis Renee, MD
10:45-11:30
Diagnosis and Management of Accreta
11:00-11:45
Dense Tissue on MMG - Now What?
Rupesh Patel, DO
Terrance Barrett, DO
8:30-9:15
9:15-10:00
Risk Management Strategies
Rick Reznicsek, JD
The Dysfunctional Physician
11:30-12:15 PM Multifetal Pregnancies
11:45-12:45 PM ACOOG MEMBERSHIP LUNCHEON
Eric Carlson, DO
12:45-1:30
Using Vaccines in Your Practice
12:15-1:30 PM
LUNCH WITH EXHIBITORS
Alexis Renee, MD
1:30-2:15
Breastfeeding 101 - Reviewing the Benefits
1:30 - 2:15
Osteoporosis Update
David Jaspan, DO
Misha Denham, DO
2:15-3:00
Drugs in Pregnancy and Lactation
2:15-3:00
Molly Walbrown, PharmD
OMT for the Post-Partum Patient
David Boesler, DO
Distinguished Fellow Honorary Lecture
3:00-3:45
BREAK WITH EXHIBITORS
3:00-3:45 3:15-4:45
Viremia in Pregnancy
TBD
Rupesh Patel, DO
3:15-4:45
What is This Rash? Dermatology Review
6:00-7:30
Symposium - Tentative
7:00 -8:00 AM
Historian & Traditions /
Membership & Promotions Committee Meeting
8:00 - 11:00 AM MEFACOOG Meeting
Meetings:
6:30-7:30 AM
Meetings:
Resident Reporters Orientation
2:00 5:00 PM
Recert Exam
6:30 - 7:30 PM
New Fellows Reception
8:00-11:00 AM MEFACOOG Board of Trustees Meeting
2015 WINTER EDITION
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Preliminary 83rd Annual Conference
continued ...WEDNESDAY (April 13, 2016)
WEDNESDAY (April 13, 2016)
7:00-7:30
AOA President-Elect
Boyd Buser, DO
7:30-8:00
ACOG President-Elect
Thomas Gellhaus, MD
8:30-8:30
Research Thesis Award Winner
8:30-9:15
MEFACOOG Distinguished Lecture
TBD
9:15-10:00
Barbara Hawkes Lecture
TBD
BREAKOUT GROUPS
MFM
1:00-1:45
The Evolution of Maternal Genetic Screening
Stephanie Kramer, MS, CGC
1:45-2:30
Quad screen/NIPT/Genetic Amnio
Marc Parrish, DO
2:30-3:15
Sono Mini-Course/Aneuploidy Markers
Marc Parrish, DO
REI
1:00-1:45
Infertility Work-Up, Best Practices
Jennifer Nichols, DO
1:45-2:30
Oocytes preservation & Donation
10:00-10:30
BREAK
10:30-12:00
New Fellows Ceremony /
President Day Program
12:00-1:00
LUNCH
Ellen Wood, DO
1:00-1:45
BREAKOUT GROUPS
1:45-2:30
BREAKOUT GROUPS
2:30-3:15
Ethics in Surrogates and Uterine Transplant
2:30-3:15
BREAKOUT GROUPS
3:15-3:30
BREAK
3:30-4:15
OMT for the Antepartum Patient
1:00-1:45
Updates in management of urinary
incontinence
Mark Sandhouse, DO
Earle Pescatore, DO
4:15-5:00
OMT for CPP
1:45-2:30
Complications of Slings
Mark Sandhouse, DO
Carlos Roberts, MD
2:30-3:15
POP: Options for Management
Carlos Roberts, MD
1:30p-3:00p
ACOOG Re-Org
Board Mtg
Kavita Arora, MD
FPRMS
GYN ONC
1:00-1:45
Gestational Trophoblastic Disease (GTD)
Timothy McGuinness, DO
1:45-2:30
Endometrial Hyperplasia in Young Adults
Tim Chad McCormick, DO
2:30-3:15
Borderline Ovarian Tumor
Timothy McGuinness, DO
Meetings:
1:30p-3:00p
Re-Org Board of Trustees
Event:
7:30-10:30
30
ACOOG
2015 WINTER EDITION
Presidential Celebration
Preliminary 83rd Annual Conference
THURSDAY (April 14, 2016)
FRIDAY(April 15, 2016)
Breakfast Symposium - TENTATIVE
6:30-8:00 Breakfast Symposium-TENTATIVE
BREAKFAST
6:30-7:00
BREAKFAST
8:00-8:40
Menopause Management
DEBATE - Conventional
7:00-7:45
Psychiatric Disorders in Pregnancy
Kenneth Johnson, DO
6:00 AM 7:30-8:00
Menopause Management DEBATE
8:40-9:20
Alternative
Lisa Eng, DO
9:20-9:35
Panel Discussion
Kenneth Johnson, DO and Lisa Eng, DO
9:35-10:15
Hormonal Therapy in Specialzed Situations
Kenneth Johnson, DO
10:00-10:15
10:15-10:30BREAK
Fararz Tyeb, DO
7:45-8:30
Reviewing the Labor Curve
Jennifer Caruso, DO
8:30-9:15
Analgesia During Labor: Complex Cas
Erik Smith, DO
9:15-10:00
Clomid vs. Letrazole, and Others
Ellen Wood, DO
10:00-10:15
BREAK
10:15-11:00
New Technologies, Techniques and Training in MIGS
Joseph Hudgens, MD
10:30-11:15
STI’s on the Rise
Diane Evans, DO
11:00-11:45
That’s endometriosis? odd presentations
and management
11:15-12:00
Weight loss Strategies
Joseph Hudgens, MD
Lisa Eng, DO
12:00-12:45 When and How to Increase Fetal Assessment
Robert Debbs, DO
12:45-1:45
Lunch
1:45-2:30
Breaking Down the Umbilical Cord Gas and
Preventing Hypoxemia
Robert Debbs, DO
2:30-3:15 Complicated Vaginitis - Best practices
Michelle L. Johnson, DO
3:15-4:00 Let’s talk about Sex - Sexual Dysfunction
Diane Evans, DO
2015 WINTER EDITION
ACOOG
31
ACOOG 83rd ANNUAL CONFERENCE
REGISTRATION FORM
PLEASE PRINT
First Name*
MI
Last Name*
AOA # *
Degree*
DO
MD
Other
Address*
Apt. or Suite
City*
State*
Zip*
Contact Tel*
E-mail *
Guest Badge **
Please print name for guest badge (Adults only)
Please list any dietary restrictions / ADA compliant accommodations.
* Required ** Adults only; includes entrance to Exhibit Hall only, daily meals not included. Please call the ACOOG office for guest meal package pricing.
Refund Policy: Written cancellation of registration by March 16, 2016 will be subject to a $50 processing fee. No refunds will be given after this date.
Special Needs: In accordance with the Americans with Disabilities Act, every effort has been made to make this conference accessible to people of all
capabilities.
Pre-Registration
Late Registration
√ GENERAL SESSION
(payment received by March 16, 2016)
(payment received after March 16, 2016)
Physician Member (Regular, Senior, Fellow, DF)
$800
$900
$1,000
$1,100
Life Member
Non-Member Physician
$525
$625
Affiliate Member (Non-physician member)
$525
$625
Candidate (Resident member)
$400
$500
Non-Member Resident
$500
$600
Student Member
Non-Member Student
$0
$0
$250
$350
For Daily registration rate please contact
the ACOOG office at 817-377-0421
Pre-registrations will be accepted until March 24, 2016 All registrations received after this date will be processed at the late registration rate. Registrations received after March
16, 2016 will be accepted on site at the registration desk only. Payment must be received in full to process registration. Faxed registrations without payment information will not be
processed.
√
SUPPLEMENTAL SESSIONS
Sub-Specialty Pre-Course REI
Day
April 10, 2016
Time
1:00-5:00 PM
CME
Limit
Fee
4
100
$150
Residents
Workshops and supplemental sessions are space limited. Your registration will be returned if a session has reached maximum capacity. Medical students may audit workshops free
of charge if space is available.
√
√
ADDITIONAL EVENTS
Time
Cost Per Ticket
ADULT Presidential Reception ticket
Day
7:00-10:00 PM
$65
CHILD Presidential Reception ticket
7:00-10:00 PM
$25
DONATION of a Presidential Reception ticket for Resident
or Student
7:00-10:00 PM
$65
MISCELLANEOUS
Amount
Black and white printed syllabus (PRE ORDER ONLY - available for pickup onsite at the registration desk)
Quantity
Quantity
$ 45
PAYMENT
Total Due
Card Type
Card #
$
Payment Method
Visa
MasterCard
Amex
Check (payable to ACOOG)
Credit Card (complete below)
Name on Card
Exp. Date
American College of Osteopathic Obstetricians and Gynecologists
8851 Camp Bowie West, Suite 275 Fort Worth, TX 76116 • Phone: 817-377-0421 • Fax 817-377-0439 • www.acoog.org

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