Amy L. Mitchell
· Associate Professor, Obstetrics and GynecologyUniversity of Arizona · Obstetrics and Gynecology
Active 1996–2016
About
Amy L. Mitchell, MD, is an Associate Professor of Obstetrics and Gynecology at the University of Arizona College of Medicine. She serves as the Vice Chair of Education within the department and is the Residency Program Director. Dr. Mitchell earned her medical degree from the University of Arizona College of Medicine in 1998 and completed her residency at the University of Arizona in 2002. She is board certified by the National Board of Medical Examiners and the American Board of Obstetrics & Gynecology. Her clinical specialties include general obstetrics and gynecology, with clinical services provided such as annual exams, birth control, laparoscopic procedures, menopause management, pelvic pain, prenatal care, sexually transmitted diseases, and ultrasound. Dr. Mitchell's professional focus encompasses education and clinical service within obstetrics and gynecology, contributing to the training of residents and the delivery of comprehensive women's health care.
Research topics
- Medicine
- Internal medicine
- Gynecology
- Psychology
- Obstetrics
Selected publications
Ethics and the Use of Animals in Art: How Art Can Progress the Discussion of Human-Animal Relations
OhioLink ETD Center (Ohio Library and Information Network) · 2016-01-01 · 1 citations
articleOpen access1st authorCorrespondingCancer Prevention Research · 2013-11-01
articleAbstract In vitro data and pilot clinical trial data suggest that green tea catechins may possess chemopreventive activity for cervical cancer and its precursor lesions. We conducted a randomized, double-blind, placebo controlled trial of Polyphenon E (decaffeinated and enriched green tea catechin extract) in women with persistent human papillomavirus (HPV) infection and low grade cervical intraepithelial neoplasia (CIN1) to evaluate the potentials of Polyphenon E for cervical cancer prevention. Ninety-eight eligible women were randomized to receive either Polyphenon E (containing 800 mg epigallocatechin gallate) or placebo once daily for 4 months. The primary study outcome was oncogenic HPV clearance and clearance of CIN1. Polyphenon E was shown to be acceptable, safe and well tolerated. There was no difference in the response rate by treatment allocation. Complete response, defined as negative for high risk HPV and normal histopathology, was noted in 7 (17.1%) and 6 (14.6%) women in the Polyphenon E and placebo arms, respectively. Partial response, defined as clearance of oncogenic HPV with evidence of CIN1, occurred more frequently in the placebo group 6 (14.6%) vs. 1 (2.4%) in the Polyphenon E arm. Progression, defined as persistent oncogenic HPV with histopathologic evidence of progression, was more common in the Polyphenon E group [3 (7.7%) vs. 6 (14.6%) in the placebo arm, although neither of these observations were statistically significant. Based on the largest randomized placebo-controlled trial of a green tea extract for HPV related cervical disease, we conclude that four months of Polyphenon E intervention did not promote the clearance of persistent high risk HPV and related CIN 1. Further studies may be necessary to better delineate the risk factors for persistent HPV infection and biology of the disease to facilitate the evaluation of chemopreventive strategies. Citation Format: Tomas Nuno, Francisco A.R. Garcia, Terri Cornelison, Amy L. Mitchell, David L. Greenspan, John W. Byron, Chiu-Hsieh Hsu, David S. Alberts, Sherry Chow. Results of a phase II randomized, double-blind, placebo controlled trial of Polyphenon E in women with persistent high-risk HPV infection and low-grade cervical intraepithelial neoplasia. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr C50.
Obstetrical & Gynecological Survey · 2011-04-01 · 9 citations
articleAtypical squamous cells of undetermined significance (ASC-US) are identified during a routine Papanicolaou screening for cervical cancer. Current strategies for cervical cancer screening use ASC-US cytology in conjunction with high-risk (HR) human papillomavirus (HPV) testing to help determine which women should be screened at increased intervals or undergo colposcopy. Before 2009, most HPV testing in the United States was performed using the Hybrid Capture II test. This prospective, multicenter clinical study evaluated the clinical performance characteristics of 2 new tests, the Cervista HPV HR and HPV 16/18 tests, for the detection of cervical intraepithelial neoplasia (CIN) 2+ and CIN 3 in women with ASC-US. The Cervista HPV HR test detects DNA from 14 HR HPV types, whereas the HPV 16/18 test is a genotyping test for the detection of HPV types 16 and 18. To perform these 2 tests, DNA was extracted from approximately 4000 liquid cytology samples obtained during routine Papanicolaou screening. Colposcopic examination was performed and the results of biopsies were collected from all study subjects with cytology results of ASC-US. The clinical performance of the HPV HR and 16/18 genotyping tests was compared with those of colposcopy and centrally confirmed histology results. Complete data sets of HR HPV and colposcopy/histology results were available for 1347 of subjects analyzed with the HPV HR test. For detection of ≥CIN 2 among women with ASC-US cytology, the sensitivity of the HPV HR test and the negative predictive value (NPV) was 92.8% (95% confidence interval [CI], 84.1–96.9) and 99.1% (95% CI, 98.1–99.6), respectively. With respect to ≥CIN 3, the sensitivity and negative predictive value of the HPV HR test was 100% (95% CI, 85.1–100) and 100% (95% CI, 99.4–100), respectively. For detection of ≥CIN 2, the specificity of the HPV HR test was 44.2% (95% CI, 41.5–46.9); for detection of ≥CIN 3, its specificity was 43% (95% CI, 40.3–45.7). The clinical performance of the HPV 16/18 test in women with ASC-US cytology who were infected with HR HPV was as expected. These findings demonstrate that Cervista HPV HR test is a clinically validated test for accurately detecting HR HPV types in women with ASC-US cytology.
Age-Stratified Performance of the Cervista HPV 16/18 Genotyping Test in Women with ASC-US Cytology
Cancer Epidemiology Biomarkers & Prevention · 2011-06-01 · 14 citations
articleBACKGROUND: The objective of this study was to evaluate the clinical performance of the Cervista HPV 16/18 genotyping test for detection of human papilloma virus (HPV) 16 and 18 in cervical cytology specimens in women stratified by age. METHODS: In a multicenter, prospective clinical study, ThinPrep specimens were tested for the presence of HPV 16 and 18 using the HPV 16/18 genotyping test. Genotyping results from women with atypical squamous cells of undetermined significance or greater cytology were compared with local colposcopy and/or histology results. Sensitivity, specificity, and negative and positive predictive values (NPV and PPV) were determined. RESULTS: The prevalence of cervical intraepithelial neoplasia (CIN) 2(+) in subjects positive for HPV 16/18 was 6.6% and 4.1% for women <30 and ≥30 years of age, respectively. The sensitivity of the test was 70.0% (95% CI: 54.6-81.9) and 66.7% (95% CI: 46.7-82.0) in women <30 and ≥30 years, respectively. The NPV was 95.5% (95% CI: 93.4-97.6) in women <30 years and 96.6% (95% CI: 94.8-98.5) in women ≥30 years. Specificity was higher in women ≥30 years (79.9%; 95% CI: 74.9-84.2) than women <30 years (61.9%; 95% CI: 57.1-66.4). The PPV was 15.2% (95% CI: 12.7-19.1) in women <30 years and 21.9% (95% CI: 17.0-30.7) in women ≥30 years. CONCLUSIONS: The performance of the Cervista HPV 16/18 genotyping test for predicting ≥CIN 2 is what would be expected across the key ≥CIN 2 age strata. IMPACT: HPV 16/18 genotyping may help further stratify women with a greater potential to develop cervical cancer.
Gynecologic Oncology · 2010-05-22 · 114 citations
articleACR North American Advances · 2007-01-01
articleClinical Cancer Research · 2007-05-01 · 113 citations
articlePURPOSE: To evaluate carcinogenic human papillomavirus (HPV) mRNA for E6 and E7 mRNA detection on clinical specimens to identify women with cervical precancer and cancer. EXPERIMENTAL DESIGN: We evaluated a prototype assay that collectively detects oncogenes E6/E7 mRNA for 14 carcinogenic HPV genotypes on a sample of liquid cytology specimens (n=531), masked to clinical data and to the presence of HPV genotypes detected by PGMY09/11 L1 consensus primer PCR assay. RESULTS: We found an increasing likelihood of testing positive for carcinogenic HPV E6/E7 mRNA with increasing severity of cytology (P(Trend) < 0.0001) and histology (P(Trend) < 0.0001), with 94% of cervical intraepithelial neoplasia grade 3 (CIN3) histology cases (46 of 49) and all five cancer cases testing positive for carcinogenic HPV E6/E7 mRNA. Overall, fewer specimens tested positive for carcinogenic HPV E6/E7 mRNA than for carcinogenic HPV DNA (P<0.0001, McNemar's chi(2) test), especially in women with <CIN1 (P<0.0001). We also found that using a higher positive cutpoint for detection of carcinogenic HPV E6/E7 mRNA improved the association of positive test results with cervical precancer and cancer by reducing the number of test positives in women without precancer without reducing clinical sensitivity for cervical precancer and cancer compared with detection of carcinogenic HPV E6/E7 mRNA using a lower positive cutpoint by the same assay and with detection of carcinogenic HPV DNA. CONCLUSIONS: We found that carcinogenic HPV E6/E7 mRNA is a potentially useful biomarker for detection of cervical precancer and cancer and warrants further evaluation.
Cancer Epidemiology Biomarkers & Prevention · 2007-04-01 · 14 citations
articleThe usefulness of mouthwash as a transport medium for cervical specimens for carcinogenic human papillomavirus (HPV) DNA testing has not been evaluated. Two cervical specimens were collected from each of 34 patients, with one placed in mouthwash (Scope, Proctor and Gamble, Inc.) and the other in a liquid cytology medium commonly used for HPV DNA testing in alternating order. Paired specimens were tested by a PCR assay for carcinogenic HPV and a PCR HPV genotyping assay for 37 HPV types at 0, 3, and 6 weeks after collection; the results of the HPV genotyping assay were categorized into HPV risk groups according to cancer risk (HPV-16 > HPV-18 > other carcinogenic HPV types > noncarcinogenic HPV types > negative). After 4 months of storage, specimens were tested using a second, non-PCR test for carcinogenic HPV. We observed a >or=94% total agreement and kappa values of >or=0.88 between media at each time point for PCR-detected carcinogenic HPV. We observed a >or=74% total agreement, >or=0.62 unweighted kappa, and >or=0.75 linearly weighted kappa between media at each time point for PCR-detected HPV cancer risk category. Finally, we observed an 88% total agreement and kappa of 0.77 between media for carcinogenic HPV detection using a second test after 4 months of storage. We suggest that mouthwash might be used as a low-cost, safe, nonflammable storage and transport medium for cervical specimens for HPV DNA testing in cervical cancer screening programs.
Psychological Bulletin · 2006-01-01 · 164 citations
reviewA meta-analysis of 166 HIV-prevention interventions tested theoretical predictions about the effects of experts, lay community members, and similar and dissimilar others, as agents of change. In general, expert interventionists produced greater behavior change than lay community members, and the demographic and behavioral similarity between the interventionist and the recipients facilitated behavioral change. Equally importantly, there were differences across groups in the efficacy of various sources, especially among populations of low status and/or power. These findings support the hypothesis that unempowered populations are more sensitive to characteristics of the interventionists who can facilitate access to various resources. In addition, they suggest the need to ensure the availability of health professionals from diverse demographic and behavioral backgrounds.
Development of Gastrointestinal Function: Risk Factors for Necrotizing Enterocolitis
The Journal of Pediatric Pharmacology and Therapeutics · 2004-04-01 · 6 citations
articleOpen accessSenior authorThe intestinal tract of the fetus matures rapidly in the third trimester of the pregnancy. The premature infant has decreased intestinal motility, limited digestion, absorption and excretion, and poor intestinal barrier defense. These limitations place the infant at high risk for acute intestinal injury, necrotizing enterocolitis. This article reviews the development of the gastrointestinal tract in the fetus, the barriers to feeding the high risk, premature infant, and the most serious intestinal disease, necrotizing enterocolitis.
Frequent coauthors
- 45 shared
Francisco García
Pima County Health Department
- 42 shared
Mark H. Einstein
Rutgers New Jersey Medical School
- 41 shared
Stephen Day
University of the West of Scotland
- 37 shared
Daron G. Ferris
- 37 shared
Marilyn C. Olson
Regenstrief Institute
- 37 shared
Mark G. Martens
Drexel University
- 5 shared
Dolores Albarracín
- 3 shared
Philip E. Castle
National Cancer Institute
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