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University of Pittsburgh Physicians
300 Halket Street
Pittsburgh, PA 15213
Phone: 412-641-4220
Fax: 412-641-1133
Faculty
 
moalli.jpg Pamela Ann Moalli, M.D., Ph.D.
Associate Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Fellowship Director, Division of Urogynecology and Pelvic Reconstructive Surgery
Magee-Womens Research Institute
20 Craft Avenue
Pittsburgh, PA 15213
Phone: 412-641-6052
Email: pmoalli@mail.magee.edu
Fax: 412-641-5290
Faculty Research Interests
 
Research Interests
Dr. Moalli is Principal Investigator of an R01 titled, “Impact of Menopause on Vaginal Connective Tissue Support “. To date, there have been no studies investigating the mechanism by which vaginal support fails following menopause. Using both human tissues and an animal models, her group is defining the pathobiology by which menopause increases the risk for prolapse. The overall hypothesis is that the synthesis and degradation of connective tissue in the vagina and its supportive tissues is regulated by estrogen and progesterone. Specifically, the group believes that hormones suppress connective tissue degradation. As a result, they employ biochemical and histomorphological assays to examine changes in connective tissue remodeling in control and prolapsed tissue with a focus on total collagen, collagen subtypes and the collagen degrading enzymes – the Matrix Metalloproteinases. In addition, the group is interested in the impact of prolapse on the biomechanical behavior of the pelvic tissues that may predispose to the progression of prolapse. Using state of the art techniques, Dr. Moalli and her colleagues interrogate the biomechanical changes in tissues using both macro and micromechanical assays.

In a second study funded by a private foundation grant, Dr. Moalli is interested in improving our understanding of Mechanisms of Maternal Birth Injury Using a Multidisciplinary Approach. Her overall hypothesis is that that specific functional adaptations must take place within the vagina to afford passage of the fetus with minimal maternal injury. In the event that these adaptations are exceeded (fetus too large for the passage), maternal injury ensues. This early injury contributes to the development of pelvic floor dysfunction later in life. She expects that an in depth understanding of vaginal adaptations requisite for delivery will lead to the establishment of mechanisms to maximize them; thereby providing clinicians with strategies (other than primary elective cesarean section) to prevent maternal birth injury. For this research initiative, she aims to define the adaptations of the vagina in pregnancy to achieve vaginal delivery and to determine the degree to which birth injury impacts tissue recovery using a rodent and primate model.
Collaborators: Department of Bioengineering – Steve Abramowitch PhD and Savio Woo PhD; Department of Cell Biology and Imaging – Simon Watkins PhD; Department of Toxicology - Robin Gandley PhD (smooth muscle physiologist
 
Education
  • M.D., Ph.D.: Northwestern University, 1986-1994
  • Residency: Magee-Womens Hospital, Pittsburgh, PA, 1994-1998
  • Fellowship: Urogynecology, Magee-Womens Research Institute, Pittsburgh, PA, 1998-2000
 
Publications
REfEREED ARTICLES:
Moalli PA, McDonald JL, Goodglick LA and Kane AB. Acute injury and regeneration of the mesothelium in response to asbestos fibers. Am J Pathol 128: 426-45, 1987.

Moalli PA, Pillay S, Weiner D, Leikin RE and Rosen ST. A mechanism of resistance to glucocorticoids in multiple myeloma: transient expression of a truncated GR mRNA. Blood 79: 213-22, 1992.

Moalli PA, Pillay S, Krett NL and Rosen ST. Alternatively Spliced Glucocorticoid Receptor mRNAs in Glucocorticoid-Resistant Human Mulitple Myeloma Cells. Cancer Res 53: 3877- 9, 1993.

Krett NL, Pillay S, Moalli PA, Greipp PR and Rosen ST. A variant glucocorticoid receptor mRNA is expressed in multiple myeloma patients. Cancer Res 55: 2727-2729, 1995.

J Novak, LA Danielson, LA Kerchner, OD Sherwood, RJ Ramirez, PA Moalli, and KP Conrad. Relaxin is Essential for Vasodilation During Pregnancy in Conscious Rats. J Clin Invest 107: 1469-75, 2001.

Franks ME, Zyczynski HM, Moalli PA, Sagan ER, Smith CP, Cannon T and Chancellor MB. Clinical Outcome and Cost Comparison with the Pubovaginal Sling Procedure Using Autologous Fascia Versus Cadaveric Dermal Patch. J Pelvic Surg 8: 19-22, 2002.

Moalli PA, Klingensmith WL and Meyn LA. Increased Expression of Matrix Metalloproteinses in the Uterine Cervix of Postmenopausal Women. J Lower Genet Tr Dis 7: 36-43, 2003.

Moalli PA, Klingensmith WL, Meyn LA and Zyczynski HM. Regulation of Matrix Metalloproteinase Expression by Estrogen in Fibroblasts that are Derived from the Female Pelvic Floor. Am J Obstet Gynecol, 2002; 187: 72-79.

Moalli PA, Jones Ivy S, Meyn LA and Zyczynski HM. Risk Factors Associated with Pelvic Floor Disorders in Women Undergoing Surgical Repair. Obstet & Gynecol 2003; 101:869-74.

Moalli PA, Talarico LC, Sung VW, Klingensmith WL, Shand SH, Meyn LA and Watkins SC. Impact of Menopause on Collagen Subtypes in the Arcus Tendineous Fasciae Pelvis. Am J Obstet Gynecol. 2004; 190: 620-7.

Moalli PA, Howden NS, Lowder JL, Navarro J, Debes KM, Abramowitch SD and Woo SL-Y. A Rat Model to Study the Structural Properties of the Vagina and its Supportive Tissues. Am J Obstet Gynecol, 192: 80-8, 2005.

Richter HE, Burgio KL, Brubaker LB, Moalli PA, Markland AD, Mallet V, Menefee SA, Johnson HW, Boreham MK, Dandreo KJ, and Stoddard AM. Factors Associated with Incontinence Frequency in a Surgical Cohort of Stress Incontinent Women. Am J Obstet Gynecol; 193: 2088-93, 2005.

PA Moalli and LA Meyn, MS. modeling of Vaginal Connective Tissue in Patients with Prolapse. Obstet Gynecol; 106: 953-63, 2005.

Richter HE, Burgio KL, Brubaker L, Moalli PA, Markland AD, Mallet V, Menefee SA, Johnson HW, Boreham MK, Dandreo KJ, Stoddard AM; Urinary Incontinence Treatment Network. Related Articles, Factors associated with incontinence frequency in a surgical cohort of stress incontinent women. Am J Obstet Gynecol;193: 2088-93, 2005

Zong W and Moalli PA. Sex Steroid Hormone Regulation of Matrix Metalloproteinase Expression in Cells Derived from the Female Pelvic Floor. Am J Obstet Gynecol, 19: 349 e1-11, 2007.

Howden NS, Zyczynski HM, Moalli PA, Sagan ER, Meyn LA, Weber AM. Comparison of autologous rectus fascia and cadaveric fascia in pubovaginal sling outcomes. Am J Obstet Gynecol, 194: 1444-9, 2006.

Lemack G, Xu Y, Brubaker L, Nager C, Chai T, Moalli P et al for the Urinary Incontinence Treatment Network. Clinical and Demographic Factors Associated with Valsalva Leak Point Pressure among Women Undergoing Burch Bladder Neck Suspension or Autologous Rectus Fascial Sling Procedures. Neurourol Urodyn; 26: 392-6, 2007.

Lowder, JL, Debes KM, Moon DK, Howden N, Abramowitch SD, and Moalli PA. Biomechanical Adaptations of the Rat Vagina and Supportive Tissues in Pregnancy to Accommodate Delivery. Obstet Gynecol; 109:136-43, 2007.

Daucher JA, Clark KA, Stolz DB, Meyn LA, and Moalli PA. Ultrastructural Adaptations in the Rat Vagina in Pregnancy to Accommodate Delivery. Obstet Gynecol; 109:128-35, 2007.

Richter HE, Goode P, Kenton K, Brown M, Burgio K, Kreder K, Moalli P, Wright J and Weber A. The Effect of Age on Short-Term Outcomes After Abdominal Surgery for Pelvic Organ Prolapse. J Am Geriatr Soc. 2007; 55: 857-63.

Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, Chai TC, Zyczynski H, Diokno AC, Tennstedt S, Nager C, Lloyd LK, FitzGerald M, Lemack GE, Johnson HW, Leng W, Mallett V, Stoddard AM, Menefee S, Varner RE, Kenton K, Moalli P, Sirls L, Dandreo KJ, Kusek JW, Nyberg LM, Steers W; Urinary Incontinence Treatment Network. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 356: 2143-55, 2007.

INVITED REVIEWS:
Moalli PA, and Rosen ST. Resistance to Glucocorticoids in Hematologic Malignancies. Leuk Lymph 15: 363-374, 1994.

Moalli PA. Biology of the Female Reproductive System. The Merck Manual of Medical Information. 3rd , 5th and 7th Edition, 2003, 2005, 2007.

Moalli PA. Cadveric Fascia Lata in Reconstructive Pelvic Surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2006; 17 Suppl 1:S48-50.

Alperin MA and Moalli PA. Connective Tissue Remodeling in the Female Pelvic Floor Current Opinions in Obstetrics and Gynecology; 18: 544-50, 2006.
 
 


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