Purpose/Objective Due to the coronavirus pandemic, virtual interviews became a mainstay of graduate dental and medical education selection processes. To gain a handle on how to navigate lingering uncertainties about how interviews should be conducted in the future, this study examined the benefits and pitfalls of the virtual interview process (VIP) and assessed program plans to implement in the next interview cycle. Methods An anonymous online survey, for completion by one program representative (director or associate director), was sent to graduate medical education (GME) and advanced dental education programs at West Virginia University ( N = 74). Results Fifty‐two (52) of the programs (70%) completed the survey. Zoom was the most frequently used interview platform (78.8%). Approximately two thirds (65.4%) of the interviewers thought VIP allowed the program to promote the university, the school, and their program and also reported experiencing video‐conferencing fatigue. About six in 10 perceive VIP can introduce bias in selecting applicants (59.6%) and potentially disadvantage some applicants (67.3%). Compared to the previous in‐person cycle, 67.4% of programs invited more applicants, and 73.1% interviewed more applicants. Regarding the 2021–2022 interview cycle, 55.8% of programs plan to offer either an in‐person or VIP, while 7.7% plan to keep their process completely virtual. Conclusion Graduate programs in this study demonstrated the indispensability of technology in transitioning from in‐person to virtual interviews during COVID‐19 pandemic. VIP has several advantages and disadvantages; this style of interview is forecasted to have a presence in applicant selection in the future.
Retroperitoneal lipomas during pregnancy are very rare. We report a case of a 29-year-old pregnant female who presented with a retroperitoneal lipoma. Our patient presented at 15-week gestation with abdominal pain, distention, and orthopnea. Due to vague symptoms and nonspecific imaging capabilities, retroperitoneal tumors in pregnancy are uniquely challenging with regard to diagnosis and treatment. We describe the unique work up of a retroperitoneal lipoma in pregnancy and the risks and benefits which were considered when optimizing care to the patient. Percutaneous core needle biopsy has accuracy rates for pathologic diagnosis of up to 98% and is largely safe to perform during pregnancy. Surgical resection of this type of tumor does not mandate cesarean delivery in subsequent pregnancies.
The objective of our study was to determine the effect of voiding positions on uroflow parameters in young, healthy nulliparous women with no pelvic floor disorders. Material and Methods. From December 2017 to February 2018, we performed a single-institution cross-sectional study with 30 healthy volunteers comparing uroflow curves in sitting and hovering positions. 49 participants were initially prescreened with a validated tool questionnaire for pelvic floor disorders and 30 participants who had absent symptoms were included for the final analysis. From the selected participants, demographics were collected and comparisons between the sitting and hovering position groups regarding the maximum flow rate (Qmax), average flow rate (Qave), voided volume (VV), and time to peak flow (TQmax) were conducted using either the paired t-test or the Wilcoxon rank sum test. In addition, linear regression analysis was performed to determine whether height, BMI, and age have significant impact on the log-transformed average of the pre- and postvalues of either Qmax, Qave, VV, or TQmax, as the average of these values are not normally distributed. Results. There were no statistical differences between the hovering and sitting position groups on the maximum flow rate (p=0.93), average flow rate (p=0.82), voided volume (p=0.53), and time to peak flow (p=0.82). BMI had borderline significant impact on Qave with p value = 0.0531. Conclusion. Different voiding toileting habits do not affect the most commonly used uroflow parameters in young healthy nulliparous patients. Results need to be corroborated by a larger scale study considering the small sample size of our study.
Background As body mass index increases, the risk of postpartum infections has been shown to increase. However, most studies lump women with a body mass index (BMI) of above 40kg/m2 together, making risk assessment for women in higher BMI categories challenging. The objective of this study was to evaluate the impact of extreme obesity on postpartum infectious morbidity and wound complications during the postpartum period. Study Design The present study is a secondary analysis of women who underwent cesarean delivery and had BMI > 40 kg/m2 in the Maternal Fetal Medicine Units Cesarean Registry. The primary outcome was a composite of postpartum infectious morbidity including endometritis, wound infection, inpatient wound complication prior to discharge, and readmission due to wound complications. Appropriate statistics used to compare baseline demographics, pregnancy complications, and primary outcomes among women by increasing BMI groups (40-49.9kg/m2, 50-59.9kg/m2, 60-69.9kg/m2, and >70kg/m2). Results Rates of postpartum infectious morbidity increased with BMI category (11.7% body mass index 50-59.9 kg/m2; 13.7% BMI 60-69.9 kg/m2, 21.9%; and BMI >70+ kg/m2; p=0.001). Readmission for wound complications also increased with BMI (3.1% for BMI 50-59.9 kg/m2; 6.2% for BMI 60-69.9 kg/m2; and 9.4% for BMI >70+kg/m2; p=0.001). After adjusting for confounders, increased BMI 70+ kg/m2 category remained the most significant predictor of postpartum infectious complications compared to women with BMI 40-49.9 kg/m2 (aOR 6.38; 95% CI 1.37-29.7). The adjusted odds of readmission also increased with BMI (aOR 2.33 (95%CI 1.35-4.02) BMI 50-59.9kg/m2, aOR 4.91 (95% CI 2.07-11.7) BMI 60-69.9kg/m2, aOR 36.2 (7.45-176) for BMI >70kg/m2). Conclusion Women with BMI 50-70+kg/m2 are at an increased risk of postpartum wound infections and complications compared to women with BMI 40-49.9kg/m2. These data provide increased guidance for counseling women with an extremely elevated body mass index and highlight the importance of postpartum wound prevention bundles.
INTRODUCTION The teenage birth rate in West Virginia (WV) remains among the highest in the United States. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend long-acting reversible contraception (LARC) as first-line contraception. Because WV teenagers' LARC use is exceptionally low, the objective of this study was to gain insight into the current knowledge, practice, and beliefs of health care providers (HCP) in WV regarding LARC for adolescent patients. METHODS An electronic survey using Qualtrics.com was distributed to WV HCPs. Of the 2,196 HCPs contacted, 132 respondents returned the survey, and 109 completed usable data. RESULTS A majority of HCPs were aware that LARC (i.e., intrauterine devices and implantable devices) is the first line recommendation of the ACOG and AAP for adolescent birth control. However, HCPs most frequently prescribed combination oral contraceptives and injectables, which are not first-line recommendations. Notably, 59% of HCPs prescribing combination oral contraceptives believed they were prescribing according to COG and AAP recommendations. Forty-one percent of HCPs knew that combination oral contraceptives were not a first-line recommendation but prescribed them most often. The most frequently identified most important reason for not prescribing LARC was that the HCP did not know how to place them (16.5% of respondents), followed by litigious or malpractice action if there is a malfunction or complication (4.6% of respondents). DISCUSSION These results indicate a need to provide adequate LARC training to HCPs in WV.
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