UnivERSiTy Of wiSCOnSin DEPARTMEnT Of OBSTETRiCS AnD

Transcription

synergy
UnivERSiTy Of wiSCOnSin DEPARTMEnT Of OBSTETRiCS AnD GynECOLOGy 2009-2010 Annual Report
our mission
Our mission at the University of Wisconsin Department of Ob-Gyn
is to improve the quality of life for women in the state of Wisconsin
and beyond by providing compassionate patient care and by advancing
knowledge through research, education and advocacy. We do so in an
environment of collaboration, humility, integrity and respect.
10
1
7
3
5
9
4
cover photo
1. Joel Henry, MD
7. Stephen Rose, MD
2. Laura Sabo, MD
8. Laurel Rice, MD
3. Jennifer Stevens, MPA CPA
9. Ellen Hartenbach, MD
4. Ronald Magness, PhD
10. Gregory Bills, MD
5. Kim Miller, MD
11. Dinesh Shah, MD
6. Klaus Diem, MD
Manish Pantankar, PhD
(absent from photo)
2
8
6
11
Dear Friends,
synergy
working together to
The energy to pursue our mission, vision and goals comes from the commitment and
talent of our departmental members, including faculty, fellows, residents, administrative
staff and many others. Embracing innovation and tirelessly pursuing excellence,
devoted to the compassionate care of women across their lifespan, is what our
Department is all about.
We hope that you feel our excitement and experience the synergistic energy building in
our Department as you page through this report.
Thank you for your contributions and support.
produce a result not
obtainable by any of the
agents independently
Laurel W. Rice, MD
Professor and Chair
Department of Obstetrics and Gynecology
University of Wisconsin School of Medicine and Public Health
1
synergy | Ob-Gyn 2009-2010 Annual Report
Our newly created Departmental Steering Committees, which cross divisional barriers
and integrate functional areas, have allowed us to pursue our mission with increased
vigor. These committees include: Clinical Operations, Education, Finance, Research,
Administration and Personnel and Faculty Development. This departmental structure
has allowed us to cohesively bring together diverse perspectives and disciplines, all
under the direction of committee chairs and co-chairs.
A word from Dr. Rice
This year has been one of significant growth for the UW Department of Obstetrics
and Gynecology. Remarkable opportunities continue to exist for our ongoing work in
serving the women of Wisconsin. Forces have truly come together in unprecedented
ways to synergize our efforts in patient care, research, education and advocacy.
leadership divisions
Gynecology
The Division of Gynecology has multiple physicians and nurse
practitioners providing care at four sites throughout Madison.
Our UW Health gynecologists provide a broad range of basic
and specialized medical and surgical services, ranging from
primary gynecologic health care to treating malignancies of
the female genital tract as well as urogynecology and pelvic
reconstructive surgery. Our nationally and internationally
recognized specialists design treatment plans for women of
all ages, including the performance of numerous complicated
laparoscopic and hysteroscopic procedures.
2
RepRoductive Sciences
The basic science concentration of what the Department
leadership calls the “Research Division” has extended
this focus to develop a better understanding of the
physiologic, cellular and molecular interactions needed
to establish healthy pregnancies using both animal and
human models. The Division of Reproductive Sciences has
strategically provided greater collaborations and synergistic
interactions with the clinical divisions within the department.
Reproductive Sciences research has contributed to healthier
pregnancies, which has added benefits to society and to
healthy mothers and children. The Division of Reproductive
Sciences also provides training for numerous undergraduates,
residents, fellows, predoctoral MS, PhD and MD scholars as
well as postdoctoral scholars with emphasis on basic science
and clinical translational research.
General Obstetrics and Gynecology
The Division of General Obstetrics and Gynecology is
comprised of a team of board-certified obstetrician/
gynecologists and nurse practitioners, practicing at
six sites within the Madison area. We provide a broad
spectrum of services to women of all ages that is
unparalleled in our community. Such services include
basic and specialized medical and surgical services,
ranging from primary gynecologic health care to
advanced techniques in diagnosing and treating infertility
problems and treating malignancies of the female
genital tract. We also serve as consultants, offering
pre-conception counseling and screening, contraceptive
counseling and management, infertility evaluation and
treatment, and obstetrical consultative services.
Gynecologic Oncology
The UW Carbone Cancer Center, the state’s only
comprehensive cancer center, has the largest Gynecologic
Oncology Division in Wisconsin, offering patients state-ofthe-art care in the diagnosis and treatment of gynecologic
cancer. Our team sees more than 450 patients annually.
These patients are seen in a multidisciplinary clinic by
our team of gynecologic oncologists, medical oncologists,
radiation oncologists, genetic counselors and health
psychologists. In collaboration with UW Carbone Cancer
Center, we are committed to improving a woman’s quality of
life and minimizing side effects while undergoing therapy.
Maternal-Fetal Medicine
The Division of Maternal-Fetal Medicine (MFM) is comprised
of a team of physician specialists and fellows in training.
We practice at Meriter Hospital and at UW Hospital and
Clinics (UWHC), providing highly specialized obstetrical
services to high-risk women of all ages. Our clinical
mission is focused on compassionate care for healthy
mothers and babies in Wisconsin and beyond. We serve as
consultants to all practicing obstetricians within the local
and regional community and are skilled in a wide variety
of prenatal diagnostic procedures. We are devoted to the
education and training of medical students, residents
and our MFM fellows, and partner with members of the
Division of Reproductive Sciences for our research mission.
Collectively, we form an intellectual powerhouse in perinatal
biology in Wisconsin and beyond.
Reproductive Endocrinology and INFertility
The Division of Reproductive Endocrinology and Infertility
(REI) is comprised of three REI fellowship-trained
reproductive endocrinologists and one urologist. We
provide a broad spectrum of services to both women and
men, including infertility testing and evaluation, Assisted
Reproductive Technologies, oncofertility and many other
areas of endocrinology. We are skilled in a wide variety of
surgical procedures and serve as consultants to physicians
from a variety of local and regional practices. Our high
standard of care is not the only reason patients come to see
us. Our physicians are well-respected and highly-noted by
both their patients and their peers.
Department of Obstetrics and
Gynecology Steering Committees
Research
Ronald Magness (Chair) and Manish Patankar (Co-Chair)
Goal: To increase departmental research productivity,
including both basic science and translational research.
Education
Steve Rose (Chair) and Laura Sabo (Co-Chair)
Goal: To continue our commitment to the education of
medical students, residents, fellows, graduate students
and faculty by developing extensive, innovative curricula
and using simulation models.
Faculty Development
Ellen Hartenbach (Chair) and Dinesh Shah (Co-Chair)
Goal: To develop a comprehensive faculty development
platform that allows each faculty member to identify
and reach goals in the academic, clinical and
educational arenas.
Finance Committee
Klaus Diem (Chair) and Gregory Bills (Co-Chair)
Goal: To increase departmental reserves over the next five
years, including raising philanthropy dollars, enabling us
to meet our goals of departmental growth.
Clinical Operations
Joel Henry (Chair) and Kim Miller (Co-Chair)
Goal: To optimize our clinical operations with strategic
marketing and demographic information, to establish a
QA/QI infrastructure and function to include inpatient and
outpatient services, and to improve patient satisfaction
results and recognize top performers.
Administration
Manish Patankar (Chair) and Jennifer Stevens (Co-Chair)
Goal: To increase job satisfaction and recruitment/
retention of outstanding staff and develop a unified and
organized representation of the entire department.
The University of Wisconsin Department of Obstetrics
and Gynecology proudly and gratefully recognizes our
long-standing partners—the University of Wisconsin
School of Medicine and Public Health, the UW Medical
Foundation, the UW Hospital and Clinics and Meriter
Hospital. A unique and steadfast collaboration has
been built over the years and is now solidly in place,
sparking enhanced synergy in clinical and community
service, teaching and research. Collectively we are
sure to find continued and growing success as we
strive toward our shared vision of excellence in these
areas. Together we are bound to achieve our mission
of improving the health and well-being of women and
their families, in Wisconsin and beyond.
our Partners
Our Partners
3
Robert Golden
Dean, School of Medicine and Public Health
Vice Chancellor for Medical Affairs
Jeffrey Grossman
President and CEO
UW Medical Foundation
Donna Katen-Bahensky
President and CEO
UW Hospitals and Clinics
James Woodward
President and CEO
Meriter Hospital
compassion
Improving the quality of life for women
across the state of Wisconsin through
patient care
compassionate, high-quality health
4
care. This is the fundamental goal of
the Department of Ob-Gyn, and the focal
point at which our educational knowledge,
research discovery and community
engagement come together to touch the
lives of the women of Wisconsin.
“If you want others to be happy,
practice compassion. If you want
to be happy, practice compassion.”
– Dalai Lama
Her first appointment with Dr. Dumermuth
quickly went beyond the routine, as he discovered
additional gynecological issues that required
immediate attention. Dr. Dumermuth explained
to Mari that she would likely need surgical
treatment, and they discussed the various options
available and how they might affect her lifestyle.
This considerate discussion was particularly
important to Mari. Since she provides day care
for her grandchildren, she was concerned about
the timing of her surgery and how quickly she
could return to caring for her grandchildren.
Mari credits Dr. Dumermuth and his staff for
listening to her concerns and needs—together
they decided to schedule her surgery right
away to allow the best transition for Mari
and her family. Though the surgery was on
Christmas Eve, Mari recalls that the surgical
staff was accommodating and helpful, and
credits the staff for working diligently to
make this happen as soon as possible.
Mari’s surgery revealed additional issues which
made the procedure more in-depth than initially
expected. Mari says Dr. Dumermuth had talked
her through the many possible outcomes, so
she was prepared and not surprised. Even
with the additional issues, Mari was very
happy with the outcome of her surgery.
She was also very pleased with the follow-up
care that she received from Dr. Dumermuth
and the staff at Meriter Hospital. To help Mari
get back to caring for her grandchildren as soon
as possible, the staff at Meriter focused on
speeding her recovery. However, Mari
notes that she was not rushed—the staff
catered to her schedule, maintaining a
relaxed environment as they provided
her with top-notch recovery care.
Mari recovered in remarkable fashion,
and was soon back to taking care
of her grandchildren. She praises
Dr. Dumermuth and his staff for
taking the time to get to know a new
patient, understanding her unique
needs and developing a personal care
plan that fit her body and her life.
Generations Fertility
Care Clinic Opens
The grand opening of the new
Generations Fertility Care Clinic took
place in September of 2010. This
state-of-the-art facility was designed
specifically with the patient experience
in mind, and combines the best in
technology, comfort and care.
5
Choosing a new physician can be a daunting
task—you want someone you can trust; someone
who understands not just your body, but your
emotions; someone who will take an interest
in your life and work to develop a personal
relationship with you. When Mari Helmke
called UW Health to set up a routine Ob-Gyn
appointment, Mari chose Brent Dumermuth, MD.
patient care
New Doctor Brings a New Beginning on Christmas Eve
Reaching Out to Patients Across
the State of Wisconsin
patient care
As part of our fundamental mission, the Department
strives to improve the lives of women across the state
of Wisconsin through collaboration with physicians
and caregivers. Often this means reaching out to
provide care for patients close to their homes.
6
Denice Krofta of Tomah, WI is a proud example
of the positive outcomes of this collaborative care.
After being diagnosed with endometrial cancer,
Denice was referred to Gundersen Lutheran
Hospital in nearby La Crosse for a hysterectomy.
Denice’s pre-diabetic condition and weight
presented challenges for both the hysterectomy
procedure and her subsequent cancer treatment.
To create a surgical plan for Denice’s unique situation,
Dr. Ellen Hartenbach, Vice Chair of Obstetrics
and Gynecology at UW, collaborated with Dr. Dana
Benden, Denice’s Ob-Gyn physician at Gundersen
Lutheran. Dr. Hartenbach then came to Gundersen
Lutheran to assist Dr. Benden on a total hysterectomy.
Denice met Dr. Hartenbach shortly before her surgery,
and remembers feeling grateful. “She came all the way
from Madison,” recalls Denice. “It was wonderful.”
During the procedure, Drs. Hartenbach and
Benden discovered a 9 cm tumor in Denice’s
uterus. Fortunately, tests indicated that the cancer
had not spread, but Drs. Hartenbach and Benden
and Dr. Patrick Conway, Denice’s radiation
oncologist, began creating a treatment plan to
ensure Denice would remain cancer-free.
Denice received pelvic radiation therapy over the
next six weeks. “They wanted to treat aggressively,”
says Denice, but the focused radiation reduced the
negative impacts on the rest of Denice’s body.
Since completing radiation, Denice has
shown no signs of cancer. “Things have
been good ever since,” Denice says. While
the collaborative expertise of her doctors
played an important role, Dr. Benden
points to Denice’s positive outlook as vital
to her outcome. “Denice is a kind and
flexible person,” Benden says, “She handled
the diagnosis well and then subsequently
the ongoing radiation treatments.”
True to this positive outlook, Denice
describes her treatment as “a wonderful
experience,” noting her close relationship with
her doctors. “They’ve been just wonderful,”
Denice says, “We had a really good rapport.”
Drs. Benden and Conway recall Denice’s kind
gestures during her treatment, mentioning
a deck of personalized playing cards that
Denice created, featuring Dr. Conway’s face
on the joker card, and Dr. Benden’s
face as the wild card. “She has a great
sense of humor, which I think greatly
helps when you are faced with an
obstacle like cancer,” Benden says.
Dr. Benden also commends the
UW Department of Ob-Gyn for its
collaborative efforts with physicians
throughout the state of Wisconsin,
noting how helpful it is for patients
like Denice to receive first-rate care
“without the burden of having to travel
outside the region in which they live.”
Coming up on the five-year anniversary
which will make her officially ‘cancerfree,’ Denice thinks back on her
experience with her trademark positivity:
“It’s just wonderful.”
Kiah Walker experienced the impact of genuine patient
care. As a first-time expectant mother, Kiah had comfortably
prepared for her delivery with her own physician.
However, when her labor progressed more quickly than
expected, Kiah was induced and Dr. Kim Miller, the
on-call obstetrician, became her personal care provider.
In an instant, Kiah realized she would have to put all her
trust and confidence—for her own life and the life of her
unborn son—in the hands of a woman she had never met.
“I didn’t know her at all,” Kiah remembers, “but it was as
if she knew exactly how to put my concerns at ease—she
earned my trust and cooperation in a matter of minutes.”
Entering the Meriter birth suite filled with 10 of Kiah’s family
members, Dr. Miller excitedly connected with each individual.
As Kiah’s delivery progressed, it was Dr. Miller’s patientcentered approach that truly made an impact with Kiah.
“She connected with me, listened to me and saw my priorities
as important,” Kiah says. Noting minor complications
in the delivery, Dr. Miller explained that Kiah could
continue pushing or opt for a C-section. “She listened
to me and knew pushing was what I wanted and needed
to do before conceding to the C-section,” explains Kiah.
As a result, “I was able to ease into the idea of having
a C-section,” Kiah says. She attributes her successful
C-section and speedy recovery to Dr. Miller’s supportive
care throughout the delivery. “To me, it appeared as if there
were no moves made by Dr. Miller without my input.”
With a happy, healthy son, Kiah continues to sing the praises
of Dr. Miller: “I will forever be grateful to her for her impact
on my life and the healthy delivery of my beautiful son.”
Since the 1930s, Bucky Badger has stood
(jumped, danced and cheered) as the symbol
of the friendly face and tenacious spirit of the
University of Wisconsin, bringing together
alumni, Wisconsinites and fans around the
country. But Bucky holds a special place in the
hearts of Kim and Bob McFarlane.
Kim and her husband, Bob, first met while
students at UW-Madison. Bob’s lively character
led him to a collegiate career as Bucky Badger,
appearing at football and hockey games and
other events on campus. Soon after graduating,
Kim and Bob married and began their own
UW family: As a shout out to their alma
mater and Bob’s Bucky days, they named their
first son Brock, which means “badger” in its
English origin.
A few years after giving birth to Brock, Kim
and Bob decided to expand their family
roster. This time it did not come as easily
as the first—Kim and Bob experienced
months of roller coaster emotion as they
tried to get pregnant. Their thoughts
consumed with their desire for another
baby, the couple found it difficult to even
watch a baby-related TV show or movie, or
to see baby clothes or pregnant couples.
During this time, they managed to get pregnant
twice, but experienced further heartbreak as
one pregnancy ended in a miscarriage and
the other in an ectopic pregnancy. Finally,
Kim and Bob turned to J. Preston Parry,
MD, at Generations Fertility Care with the
Department of Ob-Gyn. The couple met with
Dr. Parry to discuss their medical histories, and
a course of testing and potential treatments.
After considering all of their options, Dr. Parry
and the McFarlanes decided to move ahead with
in vitro fertilization (IVF).
In the tenacious spirit of Bucky Badger, Kim
and Bob were determined to bring positive
thoughts and focus on this treatment plan with
a new vengeance. To their delight, shortly after
completing IVF, the McFarlanes found out they
were pregnant with twins. In the fall of 2010,
Brock welcomed Graeme and Sloan to the
McFarlane family roster.
Kim credits Dr. Parry and the Generations
Fertility Care staff with being extremely
comforting, positive and always available for
questions. The McFarlanes developed a close
relationship with the staff at Generations
Fertility Care, and Kim even says, though it was a
trying time for her family, she now misses seeing
Dr. Parry and the staff.
With the roller coaster behind them, today Kim
and Bob are happy and thankful for the friendly
faces and tenacious spirit of their three little
Bucky fans.
patient care
For most of our patients, the patient-physician relationship
is a long-term bond that grows over time. But our
physicians know that life doesn’t always go according
to plan, and when the unexpected occurs, they strive
to quickly establish a sincere connection with a new
patient, even in the most hectic of circumstances.
A Badger Family Welcomes
Bucky Twins
7
Connection Made in Minutes Will Last a Lifetime
knowledge
The Department of Ob-Gyn is proud to be
a part of the world-renowned educational
education
heritage of the University of Wisconsin.
8
Our commitment to education is reflected
in a full spectrum of programs aimed at
training the next generation of Ob-Gyn
specialists and instilling a dedication to
lifelong learning that continually enhances
the level of care available to our patients.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
– Johann von Goethe
Residency Program
The Resident Research Program, complete with
dedicated staff, faculty and advisors, allows each
resident to launch an independent research career.
The past year saw several presentations on
significant research by senior residents:
• Dr. Eliza Bennett presented on her
research, “The IUD: A survey of primary care
residents’ training, attitudes and beliefs.”
• Dr. Leslie Bradford presented on her research,
“Association of decoy receptor 3 (DcR3) levels with
tumor infiltrating lymophocytes (TILs) and tumor
vessel counts in epithelial ovarian cancer (EOC).”
• Dr. Nicole Ingrisano presented on her research,
“Use of the marmoset monkey model of female
hyposexuality to evaluate specific brain regions
involved in serotonin regulation of sexual behavior.”
• Dr. Ryan McDonald presented on his research,
“Adolescent attitudes and beliefs toward pregnancy
and contraception: an insider’s perspective.”
• Dr. Effie Siomos presented on her research,
“Repeat delivery rates in teen parents who
attend a school for pregnant/parenting teens.”
• Dr. Angela Ziebarth presented on her research,
“Diasialoganglioside GD2 expression in uterine
sarcoma: Implications for immunotherapy
with immunocytokine 14.18-IL2.”
The Residency Program proudly graduated
these six senior residents in June of 2010:
Drs. Bennett and McDonald joined the
Department, and Dr. Siomos will move
on to practice medicine in Wisconsin;
Drs. Bradford, Ingrisano and Ziebarth
have each accepted positions in prestigious
fellowship programs around the nation.
education
In its mission to train outstanding, inquisitive and
knowledgeable obstetricians and gynecologists
equipped to become leaders in the field, the
Residency Program holds a firm commitment
to innovative education and training. These
educational strengths continued to evolve in 2009
and 2010. Expanded resident education includes
new curricula covering professionalism, lifelong
learning and Council on Resident Education in
Obstetrics and Gynecology (CREOG), as well
as new mock oral exams for senior residents.
Dedicated time in the Department’s state-ofthe-art Simulation Lab has also been expanded,
allowing residents to experience additional
structured exercises that provide invaluable
hands-on opportunities for applied learning.
9
In its second year under Program Director Laura
Sabo, MD, the Residency Program in the UW
Department of Obstetrics and Gynecology
stands as a beacon of the core principles of the
Department, providing world-class training to
residents, encouraging clinical innovation through
dedicated research, and touching the greater
Wisconsin community through outstanding
patient care provided by 24 dedicated residents.
education
UW Medical Student Clerkship
10
Every medical student at the University
of Wisconsin School of Medicine and
Public Health (UWSMPH) receives
training on women’s health care
through a six-week clerkship with the
Department of Ob-Gyn. The clerkship
is offered throughout the state of
Wisconsin—Eau Claire, Green Bay,
Madison, Marshfield, Milwaukee and La
Crosse—giving students the opportunity
to experience women’s health care
in a variety of clinical settings. The
wide array of clinical experiences and
didactics familiarize students with the
core competencies of obstetrical and
gynecologic care—a dynamic specialty
that blends elements of surgery,
medicine and primary preventive care.
Medical students gain these experiences
in outpatient clinics, gynecologic
oncology, general gynecology, and
labor and delivery.
UWSMPH 4th Year Electives
The Department of Ob-Gyn offers
several electives to fourth-year medical
students interested in this field. These
include individualized clerkships in
gynecologic oncology, reproductive
endocrinology, high-risk obstetrics,
women’s reproductive health and
general gynecology. These courses are
also open to visiting students from
other medical teaching institutions. UW Health MFM Fellowship Program
The Maternal Fetal Medicine Fellowship Program
trains the miracle workers of tomorrow—experts
in care that helps to bring miracle babies into the
world under the most difficult of circumstances.
Unique among programs of its kind, the three-year
MFM Fellowship elevates its emphasis on education
and research with a curriculum that puts each fellow
through the UW Endocrinology & Reproductive
Physiology Graduate Program. Supported by the
strong tradition of basic and translational research
at UW, each fellow conducts research that serves
as the basis for a master’s-level thesis. Fellows
apply the basic research to patient care during
rigorous clinical training in specialties ranging
from clinical genetics to neonatal intensive care.
The three-year MFM Fellowship adds one new
fellow each year, allowing for in-depth training. Since
its launch in 2007, the program has produced two
graduates, and will proudly graduate two more in
2011. The fellowship program continues to produce
pioneering research in the field of MFM—current
fellows Drs. Heather Bankowski, Jennifer Krupp
and Igor Iruretagoyena are investigating fetal
dysfunction in diabetes and preeclampsia; examining
the genomic bases of fetal growth restriction; and
creating a transgenic mouse model of preeclampsia.
Gynecological Oncology Fellowship
In 2008, the Division of Gynecologic Oncology
was awarded the opportunity to shape the next
generation of leaders and innovators in the field
through the Gynecological Oncology Fellowship.
As one of only 43 gynecologic fellowships in the
nation, the three-year program encapsulates the
educational collaboration within the Department
of Ob-Gyn. Fellows begin with a year of
dedicated research, supported by the strong
research tradition of both the Department and
UW Carbone Comprehensive Cancer Center.
They then enter two years of intensive clinical
training to develop solid patient care skills
in this cross-disciplinary field. The clinical
curriculum draws on expertise throughout UW
Hospital & Clinics, as fellows learn to perform
complex surgical procedures, administer
chemotherapy and provide palliative care.
The Division of Gynecologic Oncology
is proud to graduate its first two fellows in
2011: Dr. Ahmed Al-Niami and Dr. Heather
Einstein were the fellowship’s inaugural
choices in 2008, and will graduate in July
2011. Dr. Nonyem Amara Onujiogu and Dr.
Mian Shahzad are in their second and first
year of the program, respectively. Perhaps
most importantly, the development of the
fellowship has inspired a heightened focus and
interest in the field of gynecological oncology
among UW Ob-Gyn residents, building a solid
foundation of talent in this important field.
Grand Rounds is an ongoing initiative for all
medical students, residents, faculty and staff in the
Department, aimed at providing a comprehensive
knowledge of the continuously evolving literature,
new developments and relevant research findings in
the fields of obstetrics and gynecology. The Grand
Rounds program includes conferences and lectures
covering new developments and knowledge, led by
nationally-recognized experts in general Ob-Gyn and
its many subspecialties. The Journal Club, part of
Grand Rounds, specifically seeks to help participants
gain a better understanding of the basic principles
and statistical methods used in pioneering research.
In addition to the regular conferences and lectures of
Grand Rounds, the Department holds several major
conferences each year, bringing experts in the field of
Ob-Gyn from around the nation for a collaborative
discussion of innovative concepts. In 2010, UW-Madison
and the Department of Ob-Gyn hosted the eleventh
annual Clinical Embryology Summit, an event aimed
at bringing new knowledge in Assisted Reproduction
Technology into clinical practice. The 2010 Summit was
organized by Jason Swain, PhD, from the University of
Michigan’s Center for Reproductive Medicine, and brought
national leaders in clinical embryology to Madison for
two days of collaborative discussion and learning.
The 2010 Summit centered on Dr. Swain’s presentation,
“Improving IVF Outcomes from the Laboratory,” and
featured small-group sessions focusing on optimizing
culture conditions and minimizing stresses on gametes
and embryos to improve embryo development. The
Summit is built around these smaller, focused sessions,
enhancing involvement from all attendees and building the
core understanding of concepts necessary to bring new
technology and knowledge into clinical practice.
Together, these educational initiatives provide the
foundational knowledge for innovative clinical
practices and improved patient outcomes.
Hands-On Learning
To complement the Grand Rounds and Continuing
Medical Education (CME) programs, the Department
offers several hands-on training programs. These
programs allow learners to apply their training in
a supervised setting, and obtain direct feedback to
enhance their training.
Medical students in their first and second years at the
UWSMPH participate in the Patient, Doctor and
Society (PDS) program. This integrated curriculum
is an opportunity for medical students to gain ‘handson’ learning, as they practice medical interviewing
and general physical examination using standardized
patients. Medical students also participate in small
group discussions on medical ethics, and are required
to make several oral case presentations.
At the end of their third year, medical students at
UWSMPH take the Year-End Professional Skills
Assessment (YEPSA). Medical students are observed
and assessed by Ob-Gyn faculty during 15 minutes with
a standardized patient. YEPSA pushes medical students
to achieve a high level of primary care proficiency
before entering their fourth year.
Redefining ‘hands-on learning,’ the Department’s
Women and Infants’ Simulation and Education
Lab, located at Meriter Hospital, continues to add
new curricula to its high-tech surgical simulation
program. Cutting-edge simulation equipment uses
video and 3D animation, as well as computerized
scoring, to provide an invaluable surgical simulation
experience to medical students, residents and faculty
in the Department of Ob-Gyn. Medical students
practice infant delivery and the basic skills of suturing
and knot-tying, while residents and faculty use the
Sim Lab to practice and perfect complex obstetrical
emergency surgeries and laparoscopic procedures.
Moving toward a goal of interdisciplinary simulation
exercises in real-time, the last year saw the Sim Lab
expand to include training for several specialties.
Pediatric residents practice neonatal resuscitation;
while UW nurses and anesthesiologists at Meriter
Hospital have collaborated with the Department in
training for obstetric emergency procedures.
The knowledge and skills gained through Sim Lab
training enhance patient outcomes every day, as
complex procedures and emergency situations are
handled with skill and expertise.
education
As part of a dedication to continued learning, the
Department strives to keep all faculty and staff
at the cutting edge of knowledge in obstetrics
and gynecology through various opportunities
for instructional and interactive education.
In late 2009, the Department partnered with the
office of Continuing Professional Development and
the UW Center for Women’s Health Research to host
the Innovations in Women’s Health Research
conference. Over the course of two days, experts
presented cutting-edge updates and clinical techniques
on a variety of women’s health topics, including
infertility, cancer, prenatal care, endometriosis,
menopause and more. Attendees included medical
students, faculty and staff from the Department of
Ob-Gyn, as well as a diverse crowd from the greater
UW community and the region.
11
Instructional Programs
discovery
As part of the strong tradition of
pioneering research at the University
research
of Wisconsin-Madison, the Department
12
of Ob-Gyn is proud of the continued,
diverse accomplishments of our research
division. We strive to facilitate consistent
exploration through an overarching spirit
of collaboration that drives discovery.
“The beginning of knowledge is
the discovery of something we
do not understand.”
– Frank Herbert
“Hair Study” Takes Big Step
The “hair study” traces its ‘roots’ back nearly 30 years
to 1981, when Dr. Abbott first came to UW from
Scotland’s University of Edinburgh for post-doctoral
study at the WNPRC. A few years later, while working
in London, Dr. Abbott heard about a UW primate
study showing that in utero testosterone exposure could
reprogram behavior. “I said, ‘Oh, early exposure to
testosterone? How interesting,’” Dr. Abbott remembers.
He immediately saw a connection to PCOS, a disease
that puzzled the field of endocrinology and reproductive
physiology. “Nobody knew what on earth caused it,” Dr.
Abbott explains, “Just that the ovary produced too much
testosterone, and there were a whole series of metabolic
issues that were life-threatening, as well as the infertility
issues.” Dr. Abbott hypothesized that in utero testosterone
exposure caused the expression of the metabolic and
Dr. Abbott was welcomed back to UW in 1991,
beginning a PCOS study to test this hypothesis
through the WNPRC, and starting a highly successful
scientist-clinician collaboration with Dr. Daniel
Dumesic of the Department of Ob-Gyn’s REI
division which is still active today. “The answer
was ‘yes’,” Dr. Abbott says—the primate fetuses
exposed to high in utero testosterone displayed
the traits of PCOS. “Not only did we see all the
infertility aspects of PCOS,” Dr. Abbott says,
“we saw almost all of the metabolic problems
including insulin resistance and type-2 diabetes.”
With more than 20 years of research demonstrating
the effects of high in utero testosterone exposure in
his primate model, Dr. Abbott began looking for
a way to translate his research to humans. “If we
could show that human PCOS fetuses also had this
high testosterone exposure,” Dr. Abbott explains,
“our research tells us what that will produce—the
metabolic and reproductive disorders.” Dr. Abbott
knew scientists had successfully used hair to monitor
hormone levels in humans, and he saw this as the
ideal non-invasive method for observing long-term
testosterone levels—“the historical window into an
individual’s testosterone exposure,” as he describes it.
Dr. Abbott’s “hair study” recruited its first patients
at Meriter Hospital and began taking samples in
2009. A few days after birth, a small clip of hair is
taken from the newborn baby. To celebrate their
contribution to this study, the mothers receive
a commemorative plaque displaying a tuft of
their child’s hair. “It’s a nice touch,” Dr. Abbott
says, “and the response has been wonderful.”
As a shining example of collaboration across
the UW, the study partners Dr. Abbott’s research
program with the Department of Ob-Gyn, Meriter
clinical staff and the UW Office of Clinical Trials.
“This wouldn’t be possible,” stresses
Dr. Abbott, “without the contributions of
each of these parties.”
Dr. Abbott explains it as a “basic scientist/
clinician matchup,” with David Abbott, PhD,
providing the scientific guidance for the
study and Dinesh Shah, MD, connecting with
clinical patients at Meriter. “This wouldn’t be
possible,” stresses Dr. Abbott, “without the
contributions of each of these parties.”
Next up on Dr. Abbott’s to-do list: creating
a pediatric profile for children showing high
testosterone exposure in their hair samples. This
profile will show researchers “what we need to
combat and correct,” Dr. Abbott explains. For
example, if Dr. Abbott’s research demonstrates
that children showing high testosterone exposure
are directly linked with adult-onset obesity and
type-2 diabetes, “we could target the pediatric years
with lifestyle interventions,” Dr. Abbott says, “and
possibly prevent the whole negative trajectory.”
On an even broader level, Dr. Abbott notes
his research has supported an increased focus
on glucoregulation in pregnancy. During his
primate study, Dr. Abbott saw poor maternal
glucoregulation contributed to the expression of
pre-PCOS metabolic dysfunction in offspring.
“We now know that if you raise glucose levels
in a fetus—even moderately above normal,”
Dr. Abbott explains, “you end up putting
the fetus at risk for all sorts of adult-onset
problems when testosterone is also elevated.”
Dr. Abbott suggests an increased focus on
glucoregulation in all pregnancies—not just
high-risk cases—may be an important step
in “fighting the cycle of obesity and related
complications that currently affects our society.”
research
The “hair study,” as Dr. Abbott playfully calls it,
has “tremendous potential” for treating PCOS and
its effects. Using high testosterone exposure in utero
as a biomarker, “we can develop a pediatric profile
for these at-risk individuals,” Abbott explains. This
profile could lead to treatments, including lifestyle
interventions to prevent metabolic issues, that would
reduce the expression of PCOS in those affected.
“We already know, for example,” Abbott says, “that
if we can help obese women with PCOS lose weight,
their symptoms of PCOS are much less severe.”
reproductive issues of PCOS in the offspring. “If
you can reprogram the brain with testosterone in
utero, why not other organs?” Dr. Abbott thought.
13
UW researcher Dr. David Abbott, a tenured faculty
member in the Department of Ob-Gyn and the
Wisconsin National Primate Research Center (WNPRC),
took a major ‘baby’ step in 2010, translating more
than 20 years of research into a study on human
baby hair. Dr. Abbott began collecting hair samples
from newborns at Meriter Hospital, analyzing the
hair to study in utero testosterone levels. Dr. Abbott,
who is also a faculty trainer for the Endocrinology &
Reproductive Physiology Program, hopes to develop
a biomarker for polycystic ovary syndrome (PCOS),
a condition affecting 10 percent of women causing
fertility issues, high-risk pregnancies, and adult-onset
metabolic issues including obesity and type-2 diabetes.
UW Resident’s Research Aids FDA
research
In the ‘Age of Viagra’ and the medicalization of sex
therapy, a group of UW researchers garnered national
attention in 2009 for their study of Flibanserin, a novel
serotonin analogue evaluated by the FDA as a possible
treatment for female sexual dysfunction. Dr. Nicole
Ingrisano, at the time an Ob-Gyn resident, led the
examination as an offshoot of a larger study headed
by Dr. David Abbott with the Wisconsin National
Primate Research Center (WNPRC). Dr. Ingrisano’s
work used the common marmoset monkey as a model
to evaluate the effect of Flibanserin on modulating
female sexual behavior and neural activity in the brain.
14
In conjunction with human studies, Dr. Ingrisano’s
research provided a more in-depth examination
of the effects of the drug—brain imaging using
microPET and FMRI allowed experts to track
neural activity in the medial prefrontal cortex, an
area of the brain associated with sexual function.
Research showed Flibanserin did not provide a
demonstrable increase in sexual behavior, suggesting
the drug was not a reliable modulator of female sexual
activity. This conclusion was mirrored by human studies,
leading the FDA to reject Flibanserin as a treatment
for female sexual dysfunction. Interestingly, the drug
did increase other behaviors associated with partner
affiliation, reflecting the complex relationship between
serotonin and sexual behavior. “Unfortunately, it’s not as
simple as Viagra for women,” Dr. Ingrisano explains.
This relationship is precisely what drew Dr. Ingrisano
to the topic: “Female sexual dysfunction is not
something that, in the Ob-Gyn world, we have a
lot of comfort with because we don’t have many
treatment options,” she explains. Dr. Ingrisano
pursued this interest through the Resident Research
Program, carving her unique niche within Dr. Abbott’s
larger study. “It’s amazing the resources that are
available at this university,” says Ingrisano, noting
the various UW departments that collaborated on this study: UW staff at the Waisman
Center handled the advanced brain imaging, mapping and analysis; the UW Veterinary
School provided the imaging technology; and Dr. Abbott served as Dr. Ingrisano’s
mentor, bridging the gap between the Department of Ob-Gyn and the WNPRC.
Though her research did not uncover the next wonder drug, the study earned Dr.
Ingrisano top honors among the 2010 Resident Research presenters. Having spent her
entire undergraduate and medical school career at the UW, Dr. Ingrisano recently began
a fellowship in Seattle, practicing addiction medicine tailored to pregnant women.
Dr. Ramadoss’ research has already produced
important findings, demonstrating a breakdown in
communication between cells at the maternal-fetal
interface. “The cells get drunk,” explains Dr. Ron
Magness, Ramadoss’ research mentor, as well as Vice
Chair of Research for the Department of Ob-Gyn and
Director of the Division of Reproductive Sciences.
Further examining this communication breakdown,
Dr. Ramadoss notes that the effects may be broader
than the traditional deficits of FASD: “When you have
some sort of insult during the intrauterine phase—for
instance, undernutrition—it has been associated with
adult-onset diseases like type-2 diabetes, heart disease
and reproductive cancers,” explains Ramadoss, “so
some of these diseases we’re seeing in adults could
partly be the result of fetal alcohol exposure.”
Dr. Ramadoss hopes to use his findings to develop
therapeutic strategies to prevent or mitigate the effects
of fetal alcohol exposure. Partnering with the University’s
Biotech Center, Dr. Ramadoss has successfully used
“high-throughput proteomics”—measuring and analyzing
proteins in a sample—to create cellular signatures for
maternal alcohol consumption during pregnancy. And
with the knowledge gained on the mechanistic cellular
origins of FASD, Dr. Ramadoss is looking toward
strategies to develop nutritional and pharmaceutical
treatments to combat the negative effects of alcohol
exposure. The ultimate goal, Dr. Ramadoss explains,
Since joining the Department as a postdoctoral trainee
in 2008, Dr. Ramadoss has earned awards for his
work from the USDA, NIH, Pfizer and several other
international organizations, and in 2010 Ramadoss
received the NIH Pathway to Independence Award.
Dr. Magness notes the invaluable opportunity
to host Dr. Ramadoss: “We are thrilled to have
someone with his expertise here at UW.”
Beyond the laboratory, the UW offers unique
opportunities for Dr. Ramadoss’ research to impact
clinical practice. Wisconsin leads the nation in alcohol
consumption rates, including among women of childbearing age, and Ramadoss highlights the “rich pool of
Ob-Gyn physicians, who have a lot of opportunity to
interact with patients who may consume alcohol during
pregnancy,” as a valuable resource for translating his
research into clinical practice. “There is tremendous
clinical potential,” concludes Dr. Ramadoss.
Maternal Fetal Medine Fellows
Examine Low Uterine Blood Flow
Seeking to understand and combat the effects of
preeclampsia and diabetes during pregnancy, MFM
fellows Drs. Heather Bankowski and Jennifer Krupp
have joined with Dr. Ian Bird, Director of the
Endocrinology and Reproductive Physiology program,
to examine the mechanistic causes of low birth
weight in preeclamptic and diabetic pregnancies.
Studying umbilical cells of babies born at Meriter
Hospital, the fellows have identified a common
uterine malfunction among mothers with these
conditions: a failure of endothelial function within
the uterus, leading to insufficient uterine blood
flow during pregnancy. This low blood flow
is associated with low birth weight and linked
to adult-onset conditions including diabetes,
hypertension, obesity and metabolic syndrome.
Though the two conditions lead to a common malfunction,
the fellows have discovered a causative difference. “The
hormone responsiveness of the endothelial cells is
impaired in preeclampsia, but the actual ability to make the
dilator is impaired in the diabetics,” explains Dr. Bird. Bird
uses the analogy of a cell phone: In preeclamptic cells, the
phone signal is bad—but the cell phone is fine. In diabetic
cells, the cell phone is broken—but the signal is strong.
Turning their focus to the mechanistic origins of these
cell malfunctions, the doctors are using technology
unique to the Department to examine cell behavior in real
time—these imaging techniques “are either rare or almost
unheard-of,” Dr. Bird says. This examination showed that
affected cells retain their dysfunctional characteristics
even after removal from an abnormal environment.
“They’re not in a high-sugar, low-oxygen environment,
and they’re still abnormal,” says Dr. Bankowski. This
abnormal behavior remains after several generations
of cell replication: “The cells remember where they
came from. They’re programmed,” adds Dr. Krupp.
These “programmed” cells provide a tremendous
opportunity for research into potential treatments:
“We can now use the cultured cells to look for drugs
to repair what’s gone wrong,” Dr. Bird says. Dr. Krupp
notes that many people do not respond to conventional
hypertension treatments, which aim to relax the smooth
muscle tissue surrounding the blood vessels, preventing the
muscle from contracting the vessels. Potential endothelial
treatments for hypertension, Dr. Bird explains, could
not only improve the outcome of preeclamptic and
diabetic pregnancies, “but it may well also hold value for
the larger population suffering from hypertension.”
The research is part of the MFM fellowship’s partnership
with the Endocrinology and Reproductive Physiology
program, which allows fellows to earn a master’s degree
from the ERP program as part of their training. Drs.
Krupp and Bankowski have continued their research with
Dr. Bird, creating an invaluable synergistic opportunity:
Bird, PhD, brings more than 16 years of basic science
research in the field, while the clinical background of
Krupp and Bankowski, MDs, allows vital access to
clinical samples. Without each piece of the puzzle,
“this work just couldn’t be done,” says Dr. Bird.
research
Sadly, at least 10 in every 1000 babies in America are
exposed to alcohol prenatally, leading to a range of
deficits collectively termed Fetal Alcohol Spectrum
Disorders (FASD). Bringing a new perspective
to this widespread problem, UW researcher Dr.
Jayanth Ramadoss recently received a competitive
NIH grant for his pioneering work on the origins
of FASD. Dr. Ramadoss’ novel approach focuses
on the maternal-fetal interface—the cellular contact
points between the fetal placenta and the maternal
uterus—to examine the mechanistic cellular origins
of FASD. As part of the five-year NIH K99/R00
Pathway to Independence Award, Dr. Ramadoss aims
to develop diagnostic markers for the disorder.
is to “discover means to enhance utero-placental
function that may have enduring and life-long health
benefits for the offspring.”
15
Fetal Alcohol Expert Exploring New Frontiers
engagement
Our mission extends beyond the bedside
and the lab bench, as we strive to improve
community
the quality of life of women throughout
16
communities near and far. Together we raise
awareness about important women’s health
issues, disseminate the latest discoveries
in cutting edge treatment and research, and
celebrate the synergy of combined strengths.
Education and outreach efforts build
support for better health for all women and
their families, and help provide a financial
foundation for pioneering research and
unparalleled patient care.
“Without a sense of caring, there can
be no sense of community.”
– Anthony J. D’Angelo
With the inaugural Ben Peckham Mini-Residency
Program in April 2010, the Department kicked off a
signature tradition that will lay the foundation for the
Dr. Ben M. Peckham endowed chair. True to its name,
the Mini-Residency offers guests from the community
a crash course in the science of women’s medicine
and the latest advances in clinical care for women of
all ages. The 2010 event brought guests to Blackhawk
Country Club to explore interactive demonstrations
covering specialties from gynecological cancer to
maternal-fetal health, led by more than a dozen top
researchers and physicians from the Department.
Together with Meriter Hospital and the
entire UW Health family, the Department
and the midwifery program brought warmth
to families in need and showcased the warm
hearts of the Madison community during
the annual Blanket & Diaper Drive. They
collected diapers and new or gently used
blankets, donating more than 400 blankets
and over 2000 diapers to the South Madison
Health and Family Center-Harambee for
distribution to local families.
This exciting and engaging event aims to raise awareness
of the continuing progress in women’s medicine, as well
as the ongoing impact the Department has on the women
of Wisconsin. To promote this progress, and to ensure
that quality women’s medicine is available for future
generations of Wisconsin women, future events will raise
funds for the Dr. Ben M. Peckham endowed chair.
The late Dr. Peckham established the Department of
Obstetrics and Gynecology at UW-Madison in 1956.
Dr. Peckham’s 25 years as Department chairman
left a rich legacy that continues today. Dr. Peckham
developed the divisions of maternal-fetal medicine,
gynecologic oncology and endocrinology. He led a
community-University training effort that brought
together the obstetricians and gynecologists of the
Madison area with the UW medical school and private
hospitals of Madison, increasing faculty and resources
and graduating more than 100 residents in his time as
chair. Dr. Peckham’s sustained enthusiasm for molding
and enhancing the Department’s educational efforts
helped bring quality women’s medicine to a dramatically
larger patient base in Madison and the region.
ACOG Annual Meeting Alumni & Friends Reception
Coming together with leaders in the fields of obstetrics and gynecology, the Department
continues to host an Alumni & Friends Reception at the American College of Obstetricians
and Gynecologists Annual Clinical Meeting. The Alumni & Friends Reception is an
exciting and valuable opportunity to connect with leaders in these fields from around
the nation. The 2010 meeting, held in San Francisco, was a resounding success, and the
Department is eagerly looking forward to the 2011 ACOG meeting in Washington, D.C.
Development Leadership
As Directors of Development
for the Department and the
UW Foundation, respectively,
Gloria Frane and Nancy
Francisco-Welke have led
the way in making the many
outreach accomplishments of
the past year possible. Together
they are raising the visibility
of UW Ob-Gyn and paving
the way to better health for all
Wisconsin women.
community
Blanket & Diaper Drive
17
Ben Peckham Mini-Residency Program
community
Sparkle of Hope
Truly a shining example of community support,
the Sparkle of Hope event was created in 2009
to directly support research in the Division of
Gynecological Oncology at UW. The Department
was thrilled by the tremendous success of the
inaugural event in October of 2009. In just its
first year, Sparkle of Hope raised more than
$45,000 for vital research on gynecological
cancers that affect one out of every 20 women
today. This tremendous showing of support
owes largely to the survivors who attended
the event to share their personal journeys
through gynecological cancer. This great
beginning lays the foundation for the continued
growth of the event in the years to come.
In just its first year,
Sparkle of Hope raised
more than $45,000 for vital
research on gynecological
cancers that affect one out
of every 20 women today.
18
Jewel of an Evening
Ovarian Cancer Survivor Course
Legacy of Mary Cornelia Bradley Society
Jewel of an Evening continues to shed light on
gynecologic cancers. In an evening dedicated
to honoring gynecologic cancer patients,
survivors and families, attendees meet the
faces of gynecologic cancer and learn about
the advances in gynecologic cancer research.
The event continues to raise awareness
and encourage strength and hope for those
affected by gynecologic cancer. Fittingly,
this special event is hosted by Gilda’s Club
of Madison, an organization committed to
providing emotional and social support to
patients and families living with cancer.
Beginning in the fall of 2010, the Department
and the Division of Gynecological Oncology will
host an annual Ovarian Cancer Survivor Course.
Partnering with the UW Carbone Cancer Center and
the Gynecologic Cancer Foundation, the free course
will bring together a diverse community of those
whose lives have been impacted by ovarian cancer
for a day of learning, sharing and support. Experts
will cover a variety of topics on surviving ovarian
cancer—from diagnosis through new treatments
and the unique experiences of survivorship.
Survivors from around the region, along with
their families and friends, are invited to share their
personal journeys through ovarian cancer, building
confidence and support through shared experiences.
In 2009, the Department was honored with an
Ambassador membership in the Mary Cornelia
Bradley Society, recognizing a strong and steadfast
commitment to the American Family Children’s
Hospital. The Society and its members work to
encourage and foster support of the Children’s
Hospital, and to create a framework for this
support through events and initiatives, contributing
to the Children’s Hospital’s standing as one of
the most highly-respected in the nation.
Madison Mini-Marathon Partner
A Round Fore Friends Sponsor
The Department proudly served as the charity partner for
the second annual Madison Mini-Marathon in 2010. Bucky
and the UW marching band came out to support a soldout crowd of nearly 5,000 participants in the half-marathon
and 5K run/walk through the scenic Madison isthmus.
The Department of Ob-Gyn joined the Friends of University of Wisconsin
Hospital & Clinics as the presenting sponsor of the annual “A Round
Fore Friends” golf benefit at Bishop’s Bay Country Club. The event raised
more than $15,000 to provide resources and support programs to improve
the lives of patients of UW Hospital & Clinics and their families.
The Department teamed up
with the Green Bay Packers to
support UW’s American Family
Children’s Hospital through the
Mike & Jessica McCarthy Golf
Tournament. The event raised
more than $50,000 to help the Children’s Hospital provide world-class
care teams, family support programs, specialized equipment and facility
enhancements to every child and family who enters through its doors.
March of Dimes Sponsor
The Department is proud to be a Gold sponsor of the Madison March of
Dimes. The March of Dimes has been supporting healthy pregnancies and
healthy babies through research, care and advocacy for more than 60 years.
American Family Children’s Hospital Gala
The Department continues to be a major sponsor of the annual UW American
Family Children’s Hospital Gala. The 2010 Gala celebrated the success of the
Children’s Hospital, while challenging all those involved to “dare to dream” of
new ways the Children’s Hospital can improve the lives of children and families
throughout Wisconsin and the surrounding region. The Gala raised more than
$415,000, allowing the Children’s Hospital to outfit a new operating room, and
helping the Children’s Hospital move toward its goals of enhancing patient care
resources within the hospital and patient outreach programs across the region.
community
The Healthy Women, Healthy Babies Fund was established by
the Department in 2009, funded largely by benefits from the
2009 Madison Mini-Marathon. The Fund aims to promote
awareness about healthy lifestyles for women of all ages, and
elevate understanding of how healthy choices can impact the
lives of women, both today and for generations to come.
McCarthy Golf
Tournament Sponsor
19
Volunteers from throughout the community, including Department
faculty, staff and their families, donated their time and effort
to help make this event a resounding success. Thanks to this
volunteer support, as well as the support of the Mini-Marathon’s
sponsors and participants, the 2010 event brought a sizeable
contribution to the Healthy Women, Healthy Babies Fund.
Ob-Gyn 2009-2010 Publications
Ablove T: Post void dribbling: incidence and
risk factors. Neurourol Urodyn 2010, 29:432-436.
publications
Ablove TS, Austin JL, Phernetton TM, Magness
RR: Effects of endogenous ovarian estrogen
versus exogenous estrogen replacement on
blood flow and ERalpha and ERbeta levels in
the bladder. Reprod Sci 2009, 16:657-664.
20
Belisle JA, Horibata S, Jennifer GA, Petrie S,
Kapur A, Andre S, Gabius HJ, Rancourt C,
Connor J, Paulson JC, Patankar MS:
Identification of Siglec-9 as the receptor for
MUC16 on human NK cells, B cells, and
monocytes. Mol Cancer 2010, 9:118.
Bradford L, Swartz K, Rose S: Primary
angiosarcoma of the ovary complicated by
hemoperitoneum: a case report and review of
the literature. Arch Gynecol Obstet 2009.
Engle DB, Belisle JA, Gubbels JA, Petrie SE,
Hutson PR, Kushner DM, Patankar MS: Effect
of acetyl-l-carnitine on ovarian cancer cells’
proliferation, nerve growth factor receptor
(Trk-A and p75) expression, and the cytotoxic
potential of paclitaxel and carboplatin. Gynecol
Oncol 2009, 112:631-636.
Golos TG, Giakoumopoulos M, Garthwaite MA:
Embryonic stem cells as models of trophoblast
differentiation: progress, opportunities, and
limitations. Reproduction 2010, 140:3-9.
Jiang YZ, Wang K, Fang R, Zheng J: Expression
of aryl hydrocarbon receptor in human
placentas and fetal tissues. J Histochem Cytochem
2010, 58:679-685.
Grummer MA, Sullivan JA, Magness RR, Bird IM:
Vascular endothelial growth factor acts through
novel, pregnancy-enhanced receptor signalling
pathways to stimulate endothelial nitric oxide
synthase activity in uterine artery endothelial
cells. Biochem J 2009, 417:501-511.
Jobe SO, Ramadoss J, Koch JM, Jiang Y,
Zheng J, Magness RR: Estradiol-17beta
and its cytochrome P450- and catecholO-methyltransferase-derived metabolites
stimulate proliferation in uterine artery
endothelial cells: role of estrogen receptoralpha versus estrogen receptor-beta.
Hypertension 2010, 55:1005-1011.
Gubbels JA, Claussen N, Kapur AK, Connor JP,
Patankar MS: The detection, treatment, and
biology of epithelial ovarian cancer. J Ovarian Res
2010, 3:8.
Gubbels JA, Felder M, Horibata S, Belisle JA, Kapur
A, Holden H, Petrie S, Migneault M, Rancourt C,
Connor JP, Patankar MS: MUC16 provides immune
protection by inhibiting synapse formation
between NK and ovarian tumor cells. Mol Cancer
2010, 9:11.
Iruretagoyena JI, Bankowsky H, Heiser T, Birkeland
L, Grady M, Shah D: Outcomes for fetal echogenic
bowel during the second trimester ultrasound.
J Matern Fetal Neonatal Med 2010, 23:1271-1273.
Drenzek JG, Vidiguriene J, Vidiguris G,
Grendell RL, Dambaeva SV, Durning M,
Golos TG: Suppression of Mamu-AG by
RNA Interference. Am J Reprod Immunol 2009.
Iruretagoyena JI, Shah D: A case of severe
preeclampsia leading to the diagnosis of de novo
abnormal fatty acid metabolism and ACE gene
deletion. J Obstet Gynaecol Can 2010, 32:695-697.
Goodell CA, Belisle JA, Gubbels JA, Migneault
M, Rancourt C, Connor J, Kunnimalaiyaan M,
Kravitz R, Tucker W, Zwick M, Patankar MS:
Characterization of the tumor marker muc16
(ca125) expressed by murine ovarian tumor
cell lines and identification of a panel of
cross-reactive monoclonal antibodies.
J Ovarian Res 2009, 2:8.
Iruretagoyena JI, Trampe B, Shah D: Prenatal
diagnosis of Chiari malformation with
syringomyelia in the second trimester. J Matern
Fetal Neonatal Med 2010, 23:184-186.
Isaac C, Chertoff J, Lee B, Carnes M: Do Students’
and Authors’ Genders Affect Evaluations?
A Linguistic Analysis of Medical Student
Performance Evaluations. Acad Med 2010.
Koch JM, Ramadoss J, Magness RR: Proteomic
profile of uterine luminal fluid from early
pregnant ewes. J Proteome Res 2010, 9:3878-3885.
Laube DW: Physician accountability and
taking responsibility for ourselves: washing
the dirty white coat, one at a time. Obstet
Gynecol 2010, 116:248-253.
Laube DW: Preface: Cosmetic procedures in
gynecology. Obstet Gynecol Clin North Am 2010,
37:xiii-xiv.
Matsuo K, Eno ML, Ahn EH, Shahzad MM,
Im DD, Rosenshein NB, Sood AK: Multidrug
Resistance Gene (MDR-1) and Risk of Brain
Metastasis in Epithelial Ovarian, Fallopian
Tube, and Peritoneal Cancer. Am J Clin Oncol
2010.
Porat N, Boehnlein LM, Schouweiler CM,
Kang J, Lindheim SR: Interim analysis of
a randomized clinical trial comparing
abdominal versus transvaginal ultrasoundguided embryo transfer. J Obstet Gynaecol Res
2010, 36:384-392.
Rose Sl: Notch signaling pathway in ovarian cancer.
Int J Gynecol Cancer 2009, 19:564-566.
Rose Sl, Kunnimalaiyaan M, Drenzek J, Seiler N: Notch 1
signaling is active in ovarian cancer. Gynecol Oncol 2010,
117:130-133.
Song Y, Wang K, Chen DB, Magness RR, Zheng J:
Suppression of protein phosphatase 2 differentially
modulates VEGF- and FGF2-induced signaling in
ovine fetoplacental artery endothelial cells. Placenta
2009, 30:907-913.
Tyler CT, Rice GM, Grady M, Raca G: Mild clinical
presentation in a child with prenatally diagnosed
45,X/47,XX,+18 mosaicism. Am J Med Genet A 2009,
149A:2588-2592.
Sprague, B.J., N.C. Chesler, and R.R. Magness. 2009. Shear
stress regulation of nitric oxide production in uterine
and placental artery. Special issue: International Journal
of Developmental Biology. Edited by Joan S. Hunt and
Kent E. Thornburg. Int J Dev Biol. 2010;54 (2-3):331-9.
Sprague, B.J., T.M. Phernetton, R.R. Magness, and N.C.
Chesler. 2009. The effects of the ovarian cycle and
pregnancy on uterine vascular impedance and uterine
artery mechanics. European J Ob-Gyn Reprod Biol. 144:
S184-S191.
Wang K, Jiang YZ, Chen DB, Zheng J: Hypoxia
enhances FGF2- and VEGF-stimulated human
placental artery endothelial cell proliferation: roles of
MEK1/2/ERK1/2 and PI3K/AKT1 pathways. Placenta
2009, 30:1045-1051.
Zhu Y, B.J. Sprague, T.M. Phernetton, R.R. Magness,
and N.C. Chesler. 2009. Transmission Line
Models to Simulate the Impedance of the
Uterine Vasculature during the Ovarian Cycle
and Pregnancy. European J Ob-Gyn Reprod Biol.
144: S170-S178.
Zweifel JE, Biaggio B, Schouweiler C, lindheim SR:
Follow-up assessment of excluded oocyte donor
candidates. J Obstet Gynaecol Res 2009, 35:320-325.
find full-text online versions of
these publications through PubMed:
www.ncbi.nlm.nih.gov/pubmed
PUBLiCATiOnS
Rice lW: Hormone prevention strategies for breast,
endometrial and ovarian cancers. Gynecol Oncol 2010,
118:202-207.
Yi FX, Boeldt DS, Gifford SM, Sullivan JA,
Grummer MA, Magness RR, Bird IM: Pregnancy
enhances sustained Ca2+ bursts and endothelial
nitric oxide synthase activation in ovine uterine
artery endothelial cells through increased
connexin 43 function. Biol Reprod 2010, 82:66-75.
21
Ramadoss J, liao WX, Chen DB, Magness RR: Highthroughput caveolar proteomic signature profile for
maternal binge alcohol consumption. Alcohol 2010,
44:691-697.
UW Obstetrics and Gynecology Research Funding
6,000,000
The faculty of the Department of Ob-Gyn propose a
variety of research projects annually. Some projects
are jointly proposed with other departments and
centers within the University.
5,000,000
Federal Grants
4,000,000
Research funding from the National Institutes of
Health (NIH) has continued to show an increase
in awards through 2009-10, continuing a general
upward trend over the past five years. This is
also reflected in an increase in NIH funding to the
Department of Ob-Gyn over this past year. Currently,
the UW Department of Ob-Gyn ranks 16th in the
nation and 4th in the Big Ten Conference among
other Ob-Gyn departments receiving NIH funding.
Non-Federal Gifts & Grants
3,000,000
Federal Grants Outside Ob-Gyn
Non-Federal Outside Ob-Gyn
facts & Figures
2,000,000
1,000,000
0
2005-06
2006-07
2007-08
2008-09
2009-10
22
33.15
2009-10 total full-time equivalent faculty physicians.
Total 2009-10 Department of
Ob-Gyn office visit and consults.
36,417
2,373
Total 2009-10 deliveries by UW Ob-Gyn
at St. Mary’s Hospital (445) and Meriter
Hospital (1,928).
Publications
Total MFM Ultrasounds
18
8,700
16
8,600
14
8,500
In 2010, our Maternal-Fetal Medicine
physicians began interpreting all
departmental 20-week ultrasounds.
This policy change was part of a
larger, strategic effort to provide
superior clinical expertise and
the highest quality of care to our
expecting patients.
8,400
12
8,300
10
8,200
8
8,100
6
8,000
4
7,900
2
7,800
2006-07
2007-08
2008-09
2009-10
2009
facts & Figures
7,700
0
2010
The increase in awards correlates with the increased number
of publications within the Department.
more than
$750K
The Department of Ob-Gyn
provided more than $750,000 in
Community Care Clinical Services
in FY 2009-10.
346:66
Ratio of applications to interviews for
the Department of Ob-Gyn Residence
Program for academic year 2009-10.
38
Percent of 2009-10 Ob-Gyn
Resident Program interview
candidates with USMLE score
≥ 230 (~70th percentile).
23
Intrauterine Inseminations
Advanced Assisted Reproductive Technologies
350
50
300
40
250
Intrauterine
Inseminations
200
150
Retrieval
of Oocyte
30
20
Embryo
Transfer
100
10
facts & Figures
50
24
0
0
2008-09
2009-10
2008-09
Patient Office Encounters
In 2010, our Division of
Reproductive Endocrinology
and Infertility put the finishing
touches on their new state-of
the-art clinic, Generations
Fertility Care. Throughout the
design, planning and building
phases of the new clinic,
the Division continued to
increase their clinical activity,
demonstrating great progress
and promising statistics for
the future of the program.
2009-10
Total Work RVUs
25,000
General Obstetrics & Gynecology
20,000
Gynecology
15,000
Gynecological Oncology
10,000
Maternal Fetal Medicine
5,000
Reproductive Endocrinology & Infertility
0
REI
MFM
Gyn Onc
Gyn
Generalist
Across the Department our physicians have tremendous local, regional and national
referral relationships which result in significant consultative and evaluative patient
office encounters.
Relative Value Units (RVUs) were constructed by the Centers for Medicare and Medicaid
to assess the relative intensity with which resources are used to care for a broad range of
diseases and conditions at the procedure level. Work RVUs for the Department of Ob-Gyn,
as displayed in the graph above, have shown a consistent and stable pattern, despite
programmatic changes and economic instability.
Ob-Gyn Payer Mix Based on Charges
100%
The University of Wisconsin Medical Foundation (UWMF) overall
continues to be in a favorable market. The Department of Ob-Gyn,
by the nature of the services provided, has been somewhat insulated
from the reimbursement issues related to government payers. While
UWMF shows a fairly even distribution of charges between the three
payer types (government, HMO and other), the Department shows a
much more encouraging mix with charges to government payers at
approximately 22%, to HMOs at 51% and to other payers at 26%.
80%
Other
Government
60%
HMO
40%
facts & Figures
20%
0%
2007
2008
2009
2010
UW Ob-Gyn Deliveries/CFTE
UW Ob-Gyn Total Deliveries
2,500
185
180
2,000
175
St. Mary’s
170
Meriter
1,500
165
1,000
160
155
500
150
145
0
2005
2006
2007
2008
2009
2010
2009
2010
The physicians in the Department
of Ob-Gyn provide labor and
delivery coverage at two hospitals
within the city of Madison. In
2010 the Department realized a
continued upward trend in both
total deliveries and deliveries
per clinical full-time equivalent
faculty employee.
25
Uw Department of Obstetrics and Gynecology
1 South Park Street, Suite 555
Madison, wi 53715
608.287.2494 www.obgyn.wisc.edu
acknowledgements
Special Thanks
Annual Report Work Group
David Abbott, PhD
Daniel Dumesic, MD
Kim & Bob Mcfarlane
Michelle Albrecht
vicki Johnson
Ahmed Al-niami, MD
Heather Einstein, MD
nonyem Amara Onujiogu, MD
nicole Barreau
Justine Kessler
Heather Bankowski, MD
Mari Helmke
Jayanth Ramadoss, PhD
Chad Craighill
Lezli Redmond
Dana Benden, MD
nicole ingrisano, MD
Mian Shahzad, MD
Gloria frane
Jennifer Stevens
Eliza Bennett, MD
Denice Krofta
Dinesh Shah, MD
Kelly Hellickson
Jay Storey
ian Bird, PhD
Jennifer Krupp, MD
Effie Siomos, MD
Rachel Herbison
Cindy Tiggelaar
Leslie Bradford, MD
Ron Magness, PhD
Jason Swain, PhD
Patrick Conway, MD
Ryan McDonald, MD
Kiah walker
Brent Dumermuth, MD
®
Editing and Design
image.works
Photography
C&n Photography
The Photographer

UnivERSiTy Of wiSCOnSin DEPARTMEnT Of OBSTETRiCS AnD

Transcription

Similar documents

Company News - STA HealthCare Communications

Abbott-Interfast: Innovation is Their Tradition

The Salesi Hospital has a OB-GYN and Paediatric Emergency Room

Bergen County Office Building For Sale

4 • Wisconsin Energy Cooperative News By Reed Karaim and

8.5 x 11 Program - Association of Professors of Gynecology and

primary hospital affiliates - Medical College of Wisconsin

5221 WISCONSIN AVENUE NW | WASHINGTON, DC

Eagle River Festival of Flavors

Map Your Life - Karina Cutler-Lake / Resources for Design Students