Browsing by Author "Evans-Hoeker, Emily"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- Development of endometrial stromal sarcoma in a patient undergoing in vitro fertilization: A case reportPatel, Tulsi; Sosa-Stanley, Jessica N.; Evans-Hoeker, Emily; Osborne, Janet L. (2020-05)Development of endometrial stromal sarcoma during in vitro fertilization (IVF) is rare. We encountered a case of endometrial stromal sarcoma (ESS) presenting as a new endometrial mass in a patient undergoing donor egg IVF, despite normal imaging and exams prior to and throughout treatment. To our knowledge, this is the only report describing the rapid growth of ESS during IVF treatment. When diagnosing an endometrial stromal sarcoma, it is important for the clinician and patient to be aware that full histologic inspection is required to distinguish it from a benign neoplasm. Given the need for a hysterectomy for definitive diagnosis, this case presents ethical challenges and potential for patient distress.
- Dietary and/or physical activity interventions in women with overweight or obesity prior to fertility treatment: protocol for a systematic review and individual participant data meta-analysisEvans-Hoeker, Emily; Wang, Zheng; Groen, Henk; Cantineau, Astrid E. P.; Thurin-Kjellberg, Ann; Bergh, Christina; Laven, Joop S. E.; Dietz De Loos, Alexandra; Jiskoot, Geranne; Baillargeon, Jean-Patrice; Palomba, Stefano; Sim, Kyra; Moran, Lisa J.; Espinós, Juan J.; Moholdt, Trine; Rothberg, Amy E.; Shoupe, Donna; Hoek, Annemieke; Legro, Richard S.; Mol, Ben W.; Wang, Rui (BMJ, 2022-11-07)Introduction: Dietary and/or physical activity interventions are often recommended for women with overweight or obesity as the first step prior to fertility treatment. However, randomised controlled trials (RCTs) so far have shown inconsistent results. Therefore, we propose this individual participant data meta-analysis (IPDMA) to evaluate the effectiveness and safety of dietary and/or physical activity interventions in women with infertility and overweight or obesity on reproductive, maternal and perinatal outcomes and to explore if there are subgroup(s) of women who benefit from each specific intervention or their combination (treatment-covariate interactions). Methods and analysis: We will include RCTs with dietary and/or physical activity interventions as core interventions prior to fertility treatment in women with infertility and overweight or obesity. The primary outcome will be live birth. We will search MEDLINE, Embase, Cochrane Central Register of Controlled Trials and trial registries to identify eligible studies. We will approach authors of eligible trials to contribute individual participant data (IPD). We will perform risk of bias assessments according to the Risk of Bias 2 tool and a random-effects IPDMA. We will then explore treatment-covariate interactions for important participant-level characteristics. Ethics and dissemination: Formal ethical approval for the project (Venus-IPD) was exempted by the medical ethics committee of the University Medical Center Groningen (METc code: 2021/563, date: 17 November 2021). Data transfer agreement will be obtained from each participating institute/hospital. Outcomes will be disseminated internationally through the collaborative group, conference presentations and peer-reviewed publication. PROSPERO registration number CRD42021266201.
- Informing the development and uptake of a weight management intervention for preconception: a mixed-methods investigation of patient and provider perceptionsHarden, Samantha M.; Ramalingam, NithyaPriya S.; Wilson, Kathryn E.; Evans-Hoeker, Emily (2017-02-06)Background It is recommended for women to have a healthy body mass index before conception. However, there is limited research on appropriate preconception interventions for weight loss. Furthermore, there is a lack of knowledge on providers’ willingness to refer to particular behavioral interventions and the degree to which patients would attend those interventions. Methods A cross-section of 67 patients and 21 providers completed surveys related to their demographics and willingness to refer/attend a number of interventions for weight loss. A case study of three patients from the target audience was used to elicit detailed feedback on preconception weight status and weight loss intervention. Results Overall, patients were willing to attend a variety of interventions, regardless of BMI category. Focus group participants shared that weight loss prior to conception would be beneficial for them and their child, but cited barriers such as time, location, and the way providers encourage weight loss. Providers were willing to refer to a number of behavioral interventions, and were less willing to prescribe weight loss medications than other intervention options. Conclusions A number of intervention strategies may be well received by both patients and providers in preconception care to assist with weight loss prior to conception. Future research is needed on intervention effects and sustainability.
- Weight management perceptions and clinical practices among gynaecology providers caring for reproductive-aged patientsEvans-Hoeker, Emily; Ramalingam, N.S.; Harden, Samantha M. (Wiley, 2019-03-13)Objective Research suggests that patient and provider conversations about healthy eating and physical activity behaviours may lead to patients’ increased health behaviours, access to dietary and physical activity resources, and weight management. The American College of Obstetrics and Gynecology (ACOG) has a number of weight management intervention options, but it is unclear if providers have conversations about intervention options with their patients who are of reproductive age. The purpose of this work was to evaluate the degree to which gynaecology healthcare providers offer the weight management intervention options as recommended by ACOG. Methods Cross-sectional study of gynaecology providers in Southwest Virginia utilizing an electronic survey to identify weight management perceptions and current clinical practices. Responses were measured using quantitative methods, and agreeability and frequency responses were measured using a 5-point Likert scale. Results Twenty-three of the 31 eligible providers (74.2%) completed the survey. Providers acknowledge that patients need weight management discussions and they feel comfortable and are willing to have these discussions. While physical activity recommendations were consistent among providers, they did not reflect the complete physical activity recommendations for Americans. Consistency in dietary recommendations was lacking. Although providers make recommendations for physical activity and/or diet at least sometimes, they rarely utilize other methods of weight management as outlined in the ACOG recommendations, such as referrals to other providers, programmes or medications. Conclusions Areas for improvement in weight management practices include frequency of counselling, consistency in dietary counselling and frequency of utilization of weight loss medications and referrals to ancillary services. These results can be used to aid the development of methods for targeting these deficiencies.