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Biomedical subjects

Joseph S Sanfilippo

Publications and source records attributed to Joseph S Sanfilippo.

12 recordsLinked to original sources
PubMed2005

The impact of endometrial ablation technique at a large university women's hospital.

OBJECTIVE: To determine the effect of ThermaChoice uterine balloon system on the practice patterns of endometrial ablations performed at a large university-based teaching hospital. STUDY DESIGN: A retrospective chart review was conducted of 226 patients who underwent endometrial ablation. Data were analyzed to determine any change in the type and rate of ablations performed since the introduction of second-generation technologies. Multivariate logistic regression models were used to estimate adjusted risk factors for subsequent admission. RESULTS: A total of 72.1% of all cases were performed with the ThermaChoice uterine balloon. The postoperative admission rate was significantly higher after a balloon procedure (13.7% versus 3.1%, P=.02), with a 10.6% overall incidence of admission. Adjusting for confounding variables, more women were admitted after a balloon procedure, compared with women undergoing hysteroscopic ablation (odds ratio 5.0; 95% CI: 1.1, 22). CONCLUSION: Second-generation endometrial ablation technologies represent frequently utilized and proficient treatment modalities for dysfunctional uterine bleeding. Notwithstanding their facilitative design, clinicians should not lose sight of potential limitations of these new procedures.

Adult↗
PubMed2005

Focused assessment of surgical performance: difficulty with faculty compliance.

OBJECTIVE: This study evaluated faculty compliance in the use of the global surgical rating scale of the Objective Structured Assessment of Technical Skills to rate resident surgical performance after every endoscopic procedure. STUDY DESIGN: For this prospective cohort study, 4 faculty members in the Minimally Invasive Gynecology Surgery Program were asked to rate resident surgical performance using the Objective Structured Assessment of Technical Skills instrument after every case. Faculty compliance was analyzed with respect to the influence of the resident or surgical case characteristics. Faculty and residents completed surveys about the value of the case-by-case ratings. RESULTS: Faculty members used the Objective Structured Assessment of Technical Skills instrument 36% of the time (range, 26%-60%). Faculty member compliance did not vary according to resident or surgical case characteristics. Faculty members did not think the forms had much impact on whether they gave feedback. Residents thought the opportunity to read their ratings was helpful. CONCLUSION: Faculty member compliance with case-by-case surgical performance evaluation of the residents was low.

Clinical Competence↗
PubMed2005

Infertility classification: a work in progress sounds like SOAP revisited.

Documentation and communication regarding infertility evaluation and management continue to be a work in progress. Grading systems focused on the degree of infertility and the associated prognosis are a step in the right direction. A subjective, objective, assessment, plan (SOAP) approach is a logical way to provide a detailed method of communication and documentation when dealing with infertile couples.

Documentation↗
PubMed2004

Laparoscopy in the pediatric and adolescent population.

The use of laparoscopy by gynecologists in treating pediatric and adolescent patients is a relatively new phenomenon. This article discusses the specialized instrumentation necessary for operating on these patients and preoperative considerations and generalized techniques unique to this population. Although laparoscopy has a myriad of uses, the main focus is on the diagnosis and treatment of pelvic pain, adnexal masses, and pelvic inflammatory disease. Incidental appendectomy in these patients is also discussed.

Adolescent↗
PubMed2003

Adolescent pelvic pain.

Chronic pelvic pain is a frequent complaint in adolescent females. It is a complex disorder with multiple causes. The assessment must attempt to differentiate between gynaecological and non-gynaecological sources of pain. An understanding of the physical, cognitive and environmental factors associated with the pain are essential. Laparoscopy has been used in the assessment of CPP but a significant number of patients will have no obvious aetiology at the time of laparoscopy. For the young patient with CPP, a multidisciplinary approach may be essential to facilitate diagnosis and management. Although the symptoms may not always be curable, management that allows the young female to obtain normal or near normal function may be possible. This chapter focuses on the various causes of pelvic pain in the adolescent female with a focus on the assessment, diagnosis and treatment of the different causes.

Adolescent↗
PubMed2003

Combined hysteroscopy and laparoscopy in the treatment of interstitial pregnancy.

Traditional management of interstitial pregnancy involves laparotomy with cornual resection. Increasingly sensitive human chorionic gonadotropin assays and ultrasonography has led to earlier diagnosis of interstitial pregnancy. We report two cases of interstitial pregnancy treated with a combined hysteroscopic and laparoscopic approach. Early diagnosis of interstitial pregnancy can lead to conservative treatment options.

Adult↗
PubMed2002

Effects of laparoscopic lavage on adhesion formation and peritoneum in an animal model of pelvic inflammatory disease.

STUDY OBJECTIVES: To develop an animal model of pelvic inflammatory disease (PID) that simulates intraluminal tubal damage and adhesion formation seen in human PID, and to evaluate peritoneal effects of laparoscopic lavage with 1% povidone-iodine, 0.5% povidone-iodine, and 0.05% chlorhexidine gluconate solutions. DESIGN: Prospective, randomized, controlled study (Canadian Task Force classification I). SETTING: Animal research operating room facility. SUBJECTS: Forty-five 1-year-old Pasteurella-free New Zealand white rabbits. INTERVENTION: Laparoscopy with instillation of one of five lavage solutions after bacterial inoculation with Neisseria gonorrhoeae, Bacteroides fragilis, Escherichia coli, and Peptococcus niger. MEASUREMENTS AND MAIN RESULTS: Histologic evaluation revealed significantly more peritoneal inflammation after lavage with all three solutions than after no lavage or lavage with normal saline. Gross adhesion formation was visible in only one rabbit after lavage with normal saline. One animal having lavage with 1% povidone-iodine died immediately after injection for sedation before laparoscopic lavage, and was not included in the final results. CONCLUSION: Bacterial inoculation using an intrauterine insemination catheter did not produce clinical adhesions in 43 of 44 rabbits. Histologic evaluation revealed significantly more peritoneal inflammation in the lavage with povidone-iodine and chlorhexidine gluconate compared with no lavage or lavage with normal saline.

Analysis of Variance↗