Thannickal, Aneesa

Purpose: Palliative care focuses on providing relief from the stress and symptoms of serious illness. Obstetrician gynecologists (OBGYNs) manage a variety of complex clinical situations ranging from delivering a cancer diagnosis to caring for a neonatal demise to symptom management, all of which fall within the realm of palliative care. Palliative care is relevant to the practice of OBGYNs, yet residents rarely receive formal primary palliative care training. We sought to design, implement, and evaluate a dedicated curriculum on palliative care for OBGYN residents. Methods: We performed a needs assessment of an OBGYN residency at a single institution. This information was used to develop a multidisciplinary palliative care curriculum. Post-curriculum surveys were distributed and analyzed. Descriptive statistics were utilized. Results: Our needs assessment identified a lack of knowledge and competency in palliative care concepts and skills. Using this information, we created a multidisciplinary palliative care curriculum, including clinical experiences, chalk talks, and online didactics. Post-curriculum surveys revealed a marked improvement in both knowledge base and perceived competence. Feedback was overwhelmingly positive; residents indicated that the curriculum was both a valuable use of time and would impact their provision of care in the future. Conclusion: A dedicated palliative care curriculum is an impactful addition to OBGYN training.

Abstract Purpose We aim to evaluate the association of PCOS with eating, sleeping and sexual function disorders. Methods A comprehensive search including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through 01 August 2018 was conducted for studies reporting the prevalence of any eating, sleep or sexual function disorders in patients with PCOS. Independent reviewers selected studies and extracted data. A random‐effects model was utilized to generate pooled odds ratio (OR) and 95% confidence intervals (CI) for binary outcomes, and mean difference (MD) and 95% CI for continuous outcomes. Results We included 36 studies reporting on 349,529 patients. Compared to women without PCOS, women with PCOS were more likely to have bulimia nervosa (OR 1.37; %CI, 1.17 to 1.60), binge eating (OR 2.95; 95%CI, 1.61 to 5.42), or any eating disorder (OR 1.96; 95% CI 1.18 to 3.24); but not anorexia nervosa (OR 0.92; 95%CI, 0.78 to 1.10). Women with PCOS were more likely to have sleep disorders like hypersomnia (OR 4.39; %CI, 1.07 to 18.07) and obstructive sleep apnoea (OR 10.81; %CI, 2.39 to 48.83). Women with PCOS had lower sexual satisfaction as measured on a visual analogue scale (MD −29.67; 95% CI, −36.97 to −22.37), but no difference in Total Female Sexual Function Index (MD −0.06; 95% CI, −0.51 to 0.38). Conclusion PCOS can be associated with an increased risk of eating and sleeping disorders as well as decreased sexual satisfaction. Screening for these disorders in women with PCOS may allow early intervention and improve quality of life.