Kinetics of maternal pertussis-specific antibodies in infants of mothers vaccinated with tetanus, diphtheria and acellular pertussis (Tdap) during pregnancy.

Background: Kinetics of Tdap-induced maternally-derived antibodies in infants are poorly understood. Pre-Tdap era data suggest that maternal pertussis antibodies in infants have a half-life of approximately 5-6 weeks.

Methods: 34 mother-infant pairs had blood collected before maternal Tdap vaccination, 4 weeks later, at delivery (maternal and cord), and at infant ages 3 and 6 weeks from June 2014-March 2015.

Association of Immediate Postpartum Etonogestrel Implant Insertion and Venous Thromboembolism.

Objective: To estimate the rate of readmissions for postpartum venous thromboembolism (VTE) during the first 30 days postdelivery between women with and without the immediate postpartum insertion of the etonogestrel contraceptive implant.

Methods: The Nationwide Readmissions Database from 2016 was used to identify women with a singleton delivery, immediate postpartum insertion of the etonogestrel contraceptive implant, and readmission for VTE within 30 days of discharge. Those with a prior history of VTE or anticoagulant therapy were excluded.

Rapid Deployment of a Drive-Through Prenatal Care Model in Response to the Coronavirus Disease 2019 (COVID-19) Pandemic.

Coronavirus disease 2019 (COVID-19) has been declared a public health emergency for the entire United States. Providing access to prenatal health care while limiting exposure of both obstetric health care professionals and patients to COVID-19 is challenging. Although reductions in the frequency of prenatal visits and implementation of telehealth interventions provide some options, there still remains a need for patient-health care professional visits.

Improving Documentation of Obstetric Anal Sphincter Injuries (OASIS) Using a Standardized Electronic Template at Two University-Affiliated Institutions.

Objectives: Adequate repair is vital to reduce the long-term sequelae of obstetric anal sphincter injuries (OASIS). Sufficient documentation is necessary to reflect the quality of care provided, to guide future management, and to reduce medicolegal liability. With the advent of electronic health records, proper methods of documentation can be more easily disseminated and applied for general use.

Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review.

Background: Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown.

Obstetrician-Gynecologists' Role Conflict in a Natural Disaster: Professional Versus Family Responsibilities.

Objective: The purpose of this study was to evaluate role conflict between professional and familial responsibilities among obstetric health care providers during a natural disaster between those required to stay in the hospital versus those who were at home during a catastrophic weather event.

Methods: A survey was used of obstetric attending and resident physicians in the Baylor College of Medicine, Department of Obstetrics and Gynecology following Hurricane Harvey on August 26, 2017.

Results: Ninety one of 103 physicians (88%) completed the survey.

Association Between Third-Trimester Tdap Immunization and Neonatal Pertussis Antibody Concentration.

Importance: Immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended in the United States during weeks 27 through 36 of pregnancy to prevent life-threatening infant pertussis. The optimal gestation for immunization to maximize concentrations of neonatal pertussis toxin antibodies is unknown.

Objective: To determine pertussis toxin antibody concentrations in cord blood from neonates born to women immunized and unimmunized with Tdap vaccine in pregnancy and optimal gestational age for immunization to maximize concentrations of neonatal antibodies.

Prevalence of Vaccine Hesitancy Among Expectant Mothers in Houston, Texas.

Objective: Nonmedical exemptions continue to rise because of increasing proportions of vaccine-hesitant parents. The proportion of expectant parents who are vaccine-hesitant is currently unknown. We assessed the prevalence of vaccine hesitancy among expectant parents receiving care at an obstetrics clinic in Houston, Texas.

The Role of Obstetrics/Gynecology Hospitalists in Reducing Maternal Mortality.

The United States experienced a 6.1% annual increase in the maternal death rate from 2000 to 2013. Maternal deaths from hemorrhage and complications of preeclampsia are significant contributors to the maternal death rate.

Knowledge and attitiudes of pregnant women and their providers towards recommendations for immunization during pregnancy.

Objectives: Tetanus, diphtheria and acellular pertussis (Tdap) and influenza vaccination is recommended during each pregnancy but uptake is suboptimal. We evaluated knowledge and acceptance of vaccination recommendations among pregnant women.

Methods: Prospective, convenience survey of pregnant women presenting for antenatal care at the Pavilion for Women, Texas Children's Hospital, Houston, and their healthcare providers.

Tetanus and diphtheria toxoids and acellular pertussis vaccine uptake during pregnancy in a metropolitan tertiary care center.

Objectives: Tetanus, diphtheria and acellular pertussis (Tdap) vaccine is recommended during each pregnancy, but national uptake is poor. We assessed Tdap uptake in a tertiary referral hospital served by university-affiliated and private obstetrical offices.

Methods: Review of women delivering at Texas Children's Hospital Pavilion for Women, Houston, Texas, during April 2013-June 2014.

Myeloid Growth Factors Promote Resistance to Mycobacterial Infection by Curtailing Granuloma Necrosis through Macrophage Replenishment.

The mycobacterial ESX-1 virulence locus accelerates macrophage recruitment to the forming tuberculous granuloma. Newly recruited macrophages phagocytose previously infected apoptotic macrophages to become new bacterial growth niches. Granuloma macrophages can then necrose, releasing mycobacteria into the extracellular milieu, which potentiates their growth even further.

Prevention and management of hysterectomy complications.

Hysterectomy is the most common gynecologic surgical procedure performed in the United States. Although most hysterectomies proceed without incident, complications with serious consequences may occur. This chapter reviews the incidence, predisposing factors, intraoperative risk, diagnosis, and management and prevention of complications of hysterectomy.

Hysteroscopic sterilization in the office setting.

Hysteroscopic sterilization is growing in popularity. Nearly 500,000 women have been sterilized using this method, and an increasing number of physicians are now performing this procedure in the office setting. The office setting can provide a cost-effective, convenient, and safe environment for hysteroscopic sterilization.

Comparison of high-resolution and tandem mass spectrometry for the analysis of nerve agent metabolites in urine.

Rationale: Although use is prohibited, concerns remain for human exposure to nerve agents during decommissioning, research, and warfare. High-resolution mass spectrometry (HRMS) was compared to tandem mass spectrometry (MS/MS) analysis for the quantitation of five urinary metabolites specific to VX, Russian VX, soman, sarin and cyclosarin nerve agents. The HRMS method was further evaluated for qualitative screening of metabolites not included in the test panel.

Quantitation of tetramethylene disulfotetramine in human urine using isotope dilution gas chromatography mass spectrometry (GC/MS and GC/MS/MS).

Tetramethylene disulfotetramine (tetramine) is a rodenticide associated with numerous poisonings was extracted and quantified in human urine using both gas chromatography/mass spectrometry (GC/MS) and GC/tandem mass spectrometry (MS/MS). 1200 μL samples were prepared using a (13)C(4)-labeled internal standard, a 96-well format, and a polydivinyl-benzene solid phase extraction sorbent bed. Relative extraction recovery was greater than 80% at 100 ng/mL.

Incidence of methicillin-resistant Staphylococcus aureus in postpartum breast abscesses.

Objective: The study objective is to determine the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in postpartum breast abscesses in two Houston, TX, area hospitals.

Study Design And Methods: This is a retrospective chart review of women hospitalized for postpartum breast abscesses at Woman's Hospital of Texas and Memorial Hermann Hospital between January 1, 2000 and December 31, 2006. Patients were identified by searching admission records for ICD-9 codes related to breast abscesses.

Quantification of organophosphorus nerve agent metabolites using a reduced-volume, high-throughput sample processing format and liquid chromatography-tandem mass spectrometry.

A reduced-volume, high-throughput analytical method has been developed for the quantification of organophosphorus (OP) nerve agent metabolites in human urine. Metabolites of soman, sarin, cyclohexyl-sarin, VX, and Russian-VX were quantified down to a lowest reportable limit of 1 ng/mL in human urine. One hundred microliter urine samples were preconcentrated using normal-phase 96-well solid-phase extraction silica sorbent beds.

Zebrafish and frog models of Mycobacterium marinum infection.

Mycobacterium marinum infection of poikilothermic animals, such as fish and frogs, results in chronic granulomatous diseases that bear many similarities to mycobacterioses in mammals, including tuberculosis. This unit describes three animal models of M. marinum infection that can be used to study basic aspects of Mycobacterium-host interactions and granuloma development, as well as trafficking of immune cells in host tissues.

Aspirin administered to women at 100 mg every other day produces less platelet inhibition than aspirin administered at 81 mg per day: implications for interpreting the women's health study.

Objective: We aimed to determine the relative level of platelet inhibition achieved with low-dose aspirin (81 mg daily) compared with a very low-dose (100 mg every other day).

Background: The Womens Health Study (WHS) found that a dose of 100 mg every other day of aspirin provided protection against stroke as primary prophylaxis, but not myocardial infarction. In the United States, the most commonly prescribed dose of aspirin for primary prophylaxis is 81 mg per day.

Mycobacterium marinum infection of adult zebrafish causes caseating granulomatous tuberculosis and is moderated by adaptive immunity.

The zebrafish, a genetically tractable model vertebrate, is naturally susceptible to tuberculosis caused by Mycobacterium marinum, a close genetic relative of the causative agent of human tuberculosis, Mycobacterium tuberculosis. We previously developed a zebrafish embryo-M. marinum infection model to study host-pathogen interactions in the context of innate immunity.

Validation of a VerifyNow-P2Y12 cartridge for monitoring platelet inhibition with clopidogrel.

Despite common use of clopidogrel in patients with vascular disease, monitoring of platelet inhibition is still not conventional in clinical practice. Considering substantial response variability, when some patients may experience inadequate protection, and/or increased risk of bleeding, simple and reliable methods to control adequate antiplatelet regimen is mandatory. We validated a new VerifyNow-P2Y12 assay to measure inhibition of the P2Y12 platelet receptors by clopidogrel by evaluating its receptor specificity, precision, and potential interference with platelet count, hematocrit, age, cholesterol, triglycerides, and other antiplatelet agents.