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Good outcomes for older women who give birth at home or in a birth center

Women with some characteristics commonly thought to increase pregnancy risks — being over age 35; being overweight; and in some cases, having a vaginal birth after a cesarean section — tend to have good outcomes when they give birth at home or in a birth center, a new assessment has found.

However, women with some other risk factors, a breech baby and some other cases of vaginal birth after cesarean or VBAC, may face an increased risk of poor outcomes for themselves or their babies, researchers at Oregon State University have found. The study is believed to be the first to examine these risks and the outcomes. About 2 percent of all births in the U.S., and about 4 percent in Oregon, occur at home or in a birth center, rather than in a hospital setting. Generally, women who are considered “low-risk” are good candidates for home or birth center births, also referred to as community births, if they are attended by a midwife or other trained provider and timely access to a hospital is available.

However, there is little agreement among health providers on what should be considered low- or high-risk, and some women choose to have a community birth despite potential risks, said Marit Bovbjerg, a clinical assistant professor of epidemiology at Oregon State University and lead author of the study.

Medical ethics and the tenets of maternal autonomy dictate that women be allowed to decide where and how they wish to give birth. That’s why it’s important to have as much information as possible about potential risks, said Bovbjerg, who works in the College of Public Health and Human Sciences at OSU.

There are also risks associated with hospital births, such as increased interventions, which means there aren’t always clear answers when it comes to determining the best and safest place to give birth, said Melissa Cheyney, a medical anthropologist and associate professor in OSU’s College of Liberal Arts.

The goal of the research was to better understand the outcomes for women and babies with some of the most common pregnancy risk factors, to see how those risk factors affected outcomes.

“There’s a middle or gray area, in terms of risk, where the risk associated with community birth is only slightly elevated relative to a completely low-risk sample,” Cheyney said. “We’re trying to get more information about births that fall in that middle zone so that clinicians and pregnant women can have the best evidence available when deciding where to give birth.”

The findings were published recently in the journal Birth. Other co-authors are Jennifer Brown of University of California, Davis; and Kim J. Cox and Lawrence Leeman of the University of New Mexico. Using birth outcome data collected by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats, the researchers analyzed more than 47,000 midwife-attended community births.

They looked specifically at the independent contributions to birth outcomes of 10 common risk factors: primiparity, or giving birth for the first time; advanced maternal age, or mother over age 35; obesity; gestational diabetes; preeclampsia; post-term pregnancy, or more than 42 weeks gestation; twins; breech presentation; history of both cesarean and vaginal birth; and history of only cesarean birth.

The last two groups are both considered VBACs and hospital policies and state regulations for midwifery practice usually make no distinction between the two types. However, the researchers found a clear distinction between the two groups in terms of community birth outcomes.

Women who delivered vaginally after a previous cesarean and also had a history of previous vaginal birth had better outcomes even than those women giving birth for the first time. On the other hand, women who had never given birth to a child vaginally had an increased risk of poor outcomes in community birth settings.

“That finding suggests that current policies that universally discourage VBAC should be revisited, as the evidence does not support them,” Bovbjerg said. “Women who in the past have successfully delivered vaginally seem to do just fine the next time around, even if they have also had a previous C-section. That’s really important because some medical groups totally oppose VBACs, even in hospital settings, and many hospitals don’t offer the option of a VBAC at all.”

Researchers also found that women whose babies were in breech position had the highest rate of adverse outcome when giving birth at home or in a birth center.

There was only a slight increase in poor outcomes for women over age 35, or women who were overweight or obese, compared to those without those risk factors. In some categories, there were not enough births in the data set to properly evaluate a risk’s impact, such as with gestational diabetes and preeclampsia.

“As is appropriate, women who face high complication risks such as preeclampsia tend to plan for and choose a hospital birth, rather than a community birth,” Bovbjerg said. “But even for these women, it’s important to remember that they can choose a community birth if their faith, culture or other considerations dictate that is the best choice for them.”

The researchers emphasized that the new information about risks and outcomes can serve as an important tool in decision-making for families making very personal choices about where to give birth. “These findings help us to put information and evidence, rather than fear, at the center of discussions around informed, shared decision-making between expectant families and their health care providers,” Cheyney said.

Researchers next plan to examine how the healthcare culture and standards of care in different locations within the U.S. affect outcomes of home and birthing center deliveries.


Story Source:

Materials provided by Oregon State University. Note: Content may be edited for style and length.


Journal Reference:

  1. Marit L. Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J. Cox, Lawrence Leeman. Perspectives on risk: Assessment of risk profiles and outcomes among women planning community birth in the United States. Birth, 2017; DOI: 10.1111/birt.12288

Read this article on Science Daily: www.sciencedaily.com/releases/2017/04/170413154439.htm.

Could hot flashes indicate risk of heart disease?

Study shows younger midlife women with hot flashes more likely to have poor vascular function

Hot flashes, one of the most common symptoms of menopause, have already been shown to interfere with a woman’s overall quality of life. A new study shows that, particularly for younger midlife women (age 40-53 years), frequent hot flashes may also signal emerging vascular dysfunction that can lead to heart disease. The study outcomes are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

The study involving 272 nonsmoking women aged 40 to 60 years is the first to test the relationship between physiologically assessed hot flashes and endothelial cell (the inner lining of the blood vessels) function. The effect of hot flashes on the ability of blood vessels to dilate was documented only in the younger fertile of women in the sample. There was no association observed in the older women (age 54-60 years), indicating that early occurring hot flashes may be those most relevant to heart disease risk. The associations were independent of other heart disease risk factors.

Cardiovascular disease is the leading cause of death in women. The results from the study, “Physiologically assessed hot flashes and endothelial function among midlife women,” may offer valuable information for healthcare providers working to assess the risk of heart disease in their menopausal patients. Hot flashes are reported by 70% of women, with approximately one-third of them describing them as frequent or severe. Newer data indicate that hot flashes often start earlier than previously thought — possibly during the late reproductive years — and persist for a decade or more. “Hot flashes are not just a nuisance. They have been linked to cardiovascular, bone, and brain health,” says Dr. JoAnn Pinkerton, executive director of NAMS. “In this study, physiologically measured hot flashes appear linked to cardiovascular changes occurring early during the menopause transition.”

 


 

Story Source:Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.

Journal Reference:

Rebecca C. Thurston, Yuefang Chang, Emma Barinas-Mitchell, J. Richard Jennings, Roland von Känel, Doug P. Landsittel, Karen A. Matthews. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause, 2017; 1 DOI: 10.1097/GME.0000000000000857

 

Inadequate sleep may increase risk of bone loss in women

Insufficient sleep, a common problem that has been linked to chronic disease risk, might also be an unrecognized risk factor for bone loss. Results of a new study will be presented Saturday at the Endocrine Society’s 99th annual meeting in Orlando, Fla.

The study investigators found that healthy men had reduced levels of a marker of bone formation in their blood after three weeks of cumulative sleep restriction and circadian disruption, similar to that seen in jet lag or shift work, while a biological marker of bone resorption, or breakdown, was unchanged.

“This altered bone balance creates a potential bone loss window that could lead to osteoporosis and bone fractures,” lead investigator Christine Swanson, M.D., an assistant professor at the University of Colorado in Aurora, Colo., said. Swanson completed the research while she was a fellow at Oregon Health & Science University in Portland, Ore., with Drs. Eric S. Orwoll and Steven A. Shea.

“If chronic sleep disturbance is identified as a new risk factor for osteoporosis, it could help explain why there is no clear cause for osteoporosis in the approximately 50 percent of the estimated 54 million Americans with low bone mass or osteoporosis,” Swanson said.

Inadequate sleep is also prevalent, affecting more than 25 percent of the U.S. population occasionally and 10 percent frequently, the Centers for Disease Control and Prevention report.

The 10 men in this study were part of a larger study that some of Swanson’s co-authors conducted in 2012 at Brigham and Women’s Hospital in Boston, Mass. That study evaluated health consequences of sleep restriction combined with circadian disruption. Swanson defined circadian disruption as “a mismatch between your internal body clock and the environment caused by living on a shorter or longer day than 24 hours.”

Study subjects stayed in a lab, where for three weeks they went to sleep each day four hours later than the prior day, resulting in a 28-hour “day.” Swanson likened this change to “flying four time zones west every day for three weeks.” The men were allowed to sleep only 5.6 hours per 24-hour period, since short sleep is also common for night and shift workers. While awake, the men ate the same amounts of calories and nutrients throughout the study. Blood samples were obtained at baseline and again after the three weeks of sleep manipulation for measurement of bone biomarkers. Six of the men were ages 20 to 27, and the other four were ages 55 to 65. Limited funding prevented the examination of serum from the women in this study initially, but the group plans to investigate sex differences in the sleep-bone relationship in subsequent studies.

After three weeks, all men had significantly reduced levels of a bone formation marker called P1NP compared with baseline, the researchers reported. This decline was greater for the younger men than the older men: a 27 percent versus 18 percent decrease. She added that levels of the bone resorption marker CTX remained unchanged, an indication that old bone could break down without new bone being formed.

“These data suggest that sleep disruption may be most detrimental to bone metabolism earlier in life, when bone growth and accrual are crucial for long-term skeletal health,” she said. “Further studies are needed to confirm these findings and to explore if there are differences in women.”


Story Source:

Materials provided by The Endocrine Society. Note: Content may be edited for style and length.


Read this article on Science Daily: The Endocrine Society. “Prolonged sleep disturbance can lead to lower bone formation.” ScienceDaily. ScienceDaily, 2 April 2017. <www.sciencedaily.com/releases/2017/04/170402111317.htm>.

Mother’s folic acid intake during pregnancy may decrease hypertension risk in children

Avocado – rich in folic acid.

A new article published in the American Journal of Hypertension finds that babies born to mothers with cardiometabolic risk factors were less likely to develop high blood pressure if their mothers had higher levels of folate during pregnancy.

Since the late 1980s, the prevalence of childhood elevated blood pressure has increased in the United States, in particular among African Americans. From a life course perspective, childhood high blood pressure can predict higher blood pressure values later in life, and people with higher blood pressure are at greater risk of developing cardiovascular, metabolic and kidney disease and stroke. Research has also shown that maternal cardiometabolic risk factors during pregnancy — including hypertensive disorders, diabetes, and obesity — are associated with higher offspring blood pressure.

Because controlling hypertension and cardiovascular disease in adults is difficult and expensive, identifying early-life factors for the prevention of high blood pressure may be an important and cost effective public health strategy.

There is growing evidence that maternal nutrition during pregnancy, through its impact on the fetal intrauterine environment, may influence offspring cardiometabolic health. Folate, which is involved in nucleic acid synthesis, gene expression, and cellular growth, is particularly important.

In young adults, higher folic acid intake has been associated with a lower incidence of hypertension later in life. Citrus juices and dark green vegetables are good sources of folic acid. However, the role of maternal folate levels, alone or in combination with maternal cardiometabolic risk factors on child blood pressure has not been examined in a prospective birth cohort.

In the current study, researchers analyzed the data from a prospective U.S. urban birth cohort, enriched by low-income racial and ethnic minorities at high risk for elevated BP, to examine whether maternal folic acid levels and cardiometabolic risk factors individually and jointly affect offspring blood pressure.

Researchers included 1290 mother-child pairs, 67.8% of which were Black and 19.2% of which were Hispanic, recruited at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Of the mothers, 38.2% had one or more cardiometabolic risk factors; 14.6% had hypertensive disorders, 11.1% had diabetes, and 25.1% had pre-pregnancy obesity. A total of 28.7% of children had elevated systolic blood pressure at age 3-9 years. Children with higher systolic blood pressure were more likely to have mothers with pre-pregnancy obesity, hypertensive disorders, and diabetes. Children with elevated systolic blood pressure were also more likely to have lower birth weight, lower gestational age, and higher BMI.

The study findings suggest that higher levels of maternal folic acid may help counteract the adverse associations of maternal cardiometabolic risk factors with child systolic blood pressure, although maternal folic acid levels alone were not associated with child systolic blood pressure. Among children born to mothers with any of the cardiometabolic risk factors, those whose mothers had folic acid levels above the median had 40% lower odds of elevated childhood systolic blood pressure. These associations did not differ appreciably in analyses restricted to African Americans, and they were not explained by gestational age, size at birth, child postnatal folate levels or breastfeeding.

“Our study adds further evidence on the early life origins of high blood pressure,” said Dr. Xiaobin Wang, the study’s senior corresponding author. “Our findings raise the possibility that early risk assessment and intervention before conception and during pregnancy may lead to new ways to prevent high blood pressure and its consequences across lifespan and generations.”


Story Source:

Materials provided by Oxford University Press USA. Note: Content may be edited for style and length.


Journal Reference:

  1. Hongjian Wang, Noel T. Mueller, Jianping Li, Ninglin Sun, Yong Huo, Fazheng Ren, Xiaobin Wang. Association of Maternal Plasma Folate and Cardiometabolic Risk Factors in Pregnancy with Elevated Blood Pressure of Offspring in Childhood. American Journal of Hypertension, 2017; DOI: 10.1093/ajh/hpx003

Cite This Page:

Oxford University Press USA. “High folic acid level in pregnancy may decrease high blood pressure in children.” ScienceDaily. ScienceDaily, 8 March 2017. <www.sciencedaily.com/releases/2017/03/170308081047.htm>.

Most Women of Child Bearing Age Lack Knowledge of Healthy Diet Says New Study

Dr. Lela Emad of the Women’s OB/GYN Medical Group discusses the latest findings on diet and nutrition among women and offers some guidelines for women planning for pregnancy.

A new study by the University of Pittsburgh Schools of the Health Sciences uncovers a national trend toward a less than optimal diet among women prior to pregnancy. “This information is particularly concerning for women who intend to conceive,” says Dr. Lela Emad of the Women’s OB/GYN Medical Group of Santa Rosa. “It’s imperative that prior to pregnancy, women follow a higher standard of nutrition for several reasons; to ensure healthy growth of the fetus, to reduce risks associated with premature birth, and to avoid the possibility of preeclampsia and maternal obesity – both of which carry added risks to the mother and baby.”

The study, published in the Journal of the Academy of Nutrition and Dietetics, assessed more than 7,500 women participants using the Healthy Eating Index-2010, measuring quality of diet including the intake for key food groups, while also measuring the consumption of less desirable aspects of a typical American diet such as refined grains, salt and calories from solid fats and sugars from food as well as from alcohol consumption.

Ultimately, more than a third of the calories the women in the study consumed came from ‘empty calories’ from such things as;

  • sugar-sweetened beverages,
  • pasta dishes
  • grain desserts
  • Soda
  • beer, wine and spirits

“This list consists of just about everything we would recommend a woman who was in a preconception phase to avoid,” Dr. Emad points out. “A healthy diet goes a long way toward ensuring a healthy pregnancy, and planning ahead for pregnancy by participating in a Preconception Healthcare Plan is one of the best things a woman can do both for her baby and for herself.”

What is Preconception Healthcare

Preconception healthcare describes medical care provided to a woman that is designed to increase the chances of having a positive pregnancy experience and a healthy baby. Preconception healthcare is uniquely designed for every individual, customized for personal needs and circumstances. It typically offers an introduction to guidelines for a healthy diet as part of the overall education and planning process.

“We encourage parents – that is, both parents – to begin making healthy lifestyle changes up to one full year prior to trying to get pregnant,” explains Dr. Emad. “This process improves a woman’s chances of becoming pregnant and prepares her body so it can provide the best environment for her infant.” During a preconception care visit, the OB/GYN healthcare provider will focus on lifestyle, medical and family history, previous pregnancies and currently prescribed medications. In addition to diet and exercise, topics may include alcohol, tobacco, and caffeine use; recreational drug use, birth control, family histories, genetics as well as health issues and other concerns (diabetes, high blood pressure, depression, obesity, etc.)

Healthy Diet and Supplements

“We also encourage our patients and their families to adopt a nutrient rich and calorie conscious diet prior to and during pregnancy. This is the best way to prevent excessive weight gain and cut the potential risk of obstetric complications,” says Dr. Emad. “Planning ahead and taking steps to ensure optimal pre-pregnancy health is a great way to create a healthy family.”

Learning how to make smart food choices as well as being mindful about food preparation is important, as is knowing which foods to avoid or limit during pregnancy. Foods that contain sources of folic acid (vitamin B9) are important nutritional elements to incorporate into both the preconception and pregnancy diet. Folic acid helps to prevent some birth defects – particularly those affecting the brain and spinal cord. Folic acid is best taken before pregnancy and in the very early stages of pregnancy.

Although the bulk of nutrients should ideally come from eating fresh healthy foods, it is generally recommended that women start taking a prenatal vitamin supplement before pregnancy. Prenatal vitamin supplements are specifically formulated to contain all the recommended daily vitamins and minerals needed before and during pregnancy.

About Women’s OBGYN Medical Group

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.

Good news for mature women: weight loss is possible after menopause

Talk to a woman in menopause and you’re likely to hear complaints about hot flashes and an inability to lose weight, especially belly fat. A new study shows how regular exercise can help reduce weight and control bothersome symptoms such as hot flashes, even in women who previously led sedentary lifestyles. The study outcomes are being published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Decreased estrogen levels during the menopause transition often create an array of physical and mental health issues that detract from a woman’s overall quality of life. The article “Improvements in health-related qualify of life, cardio-metabolic health, and fitness in postmenopausal women after a supervised, multicomponent, adapted exercise program in a suited health promotion intervention: a multigroup study” reports on 234 Spanish postmenopausal women aged 45 to 64 years who had at least 12 months of sedentary behavior and engaged in a supervised 20-week exercise program for the study. After the intervention, the participants experienced positive changes in short- and long-term physical and mental health, including significant improvements in their cardiovascular fitness and flexibility. In addition, they achieved modest but significant reductions in their weight and body mass index, and their hot flashes were effectively managed. This is especially good news for women who are reluctant to use hormones to manage their menopause symptoms and are looking for safe but effective nonpharmacologic options without adverse effects.

“Growing evidence indicates that an active lifestyle with regular exercise enhances health, quality of life, and fitness in postmenopausal women,” says Dr. JoAnn Pinkerton, NAMS executive director. “Documented results have shown fewer hot flashes and improved mood and that, overall, women are feeling better while their health risks decrease.


Story Source:Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.


Read this article on ScienceDaily:

The North American Menopause Society (NAMS). “Weight loss actually possible after menopause.” ScienceDaily. ScienceDaily, 15 February 2017. <www.sciencedaily.com/releases/2017/02/170215084052.htm>.

Can eating soy products affect breast health?

Georgetown Lombardi Comprehensive Cancer Center researchers have used animal models to reveal new information about the impact — positive and negative — that soy consumption could have on a common breast cancer treatment.

The scientists have uncovered the biological pathways in rats by which longtime soy consumption improves effectiveness of tamoxifen and reduces breast cancer recurrence. But they also show why eating or drinking soy-based foods for the first time while being treated with tamoxifen can, conversely, reduce effectiveness of the drug, and promote recurrence.

The study, published in Clinical Cancer Research, uncovers the molecular biology behind how soy consumption, especially its most active isoflavone, genistein, affects tamoxifen — both positively and negatively.

It also mirrors what has been observed in breast cancer patients, says the study’s senior investigator Leena Hilakivi-Clarke, PhD, professor of oncology at Georgetown Lombardi.

“There has long been a paradox concerning genistein, which has the similar structure as estrogen and activates both human estrogen receptors to a degree. Estrogen drives most breast cancer growth, yet high soy intake among women in Asian countries has been linked to a breast cancer rate that is five times lower than Western women, who eat much less soy,” she says. “So why is soy, which mimics estrogen, protective in Asian women?”

More than 70 percent of the 1.67 million women diagnosed with breast cancer worldwide in 2012 was estrogen-receptor positive, and tamoxifen and other endocrine therapies meant to reduce the ability of estrogen to promote cancer growth, are the most common drugs used for these cancers. Although endocrine therapies can be highly effective in preventing or treating breast cancer, about half of patients who use them exhibit resistance and/or have cancer recurrence.

Employing a more advanced rat model of breast cancer and tamoxifen use than has been used in past studies, the researchers found that the timing of genistein intake is the central issue.

Longtime sustained use of genistein before development of breast cancer improves overall immunity against cancer, thus protecting against cancer development and recurrence, says the study’s lead researcher, Xiyuan Zhang, PhD.

“It also inhibits a mechanism called autophagy that would allow cancer cells to survive, which explains why it helps tamoxifen work,” says Zhang, a member of Hilakivi-Clarke’s laboratory when this study was conducted. She is currently a postdoctoral researcher at the National Institutes of Health.

Previous studies in women show no evidence of adverse effects of soy intake on breast cancer outcome, the researchers say, adding that research has also shown that Asian and Caucasian women who consumed as little as 1/3rd cup of soymilk daily (10 mg. of isoflavones) had the lowest risk of breast cancer recurrence.

The animal studies suggest it is a different story when soy consumption begins after breast cancer develops.

Starting consuming genistein in a diet after breast cancer develops in the animals did not trigger anti-tumor immune response to eliminate cancer cells, Zhang says. “We do not know yet why this made the animals resistant to the beneficial effects of tamoxifen and increased risk of cancer recurrence,” she continued.

Animals consuming genistein as adults on had a 7 percent chance of breast cancer recurrence after tamoxifen treatment, compared with a 33 percent recurrence with rats exposed to genistein only after breast cancer developed.

“We have solved the puzzle of genistein and breast cancer in our rat model, which perfectly explains the paradox seen in earlier animal studies and patients,” says Hilakivi-Clarke. “While many oncologists advise their patients not to take isoflavone supplements or consume soy foods, our findings suggest a more nuanced message — if these results hold true for women. Our results suggest that breast cancer patients should continue consuming soy foods after diagnosis, but not to start them if they have not consumed genistein previously.”


Story Source:

Materials provided by Georgetown University Medical Center. Note: Content may be edited for style and length.


Read this article on ScienceDaily: Georgetown University Medical Center. “Understanding when eating soy might help or harm in breast cancer treatment.” ScienceDaily. ScienceDaily, 1 February 2017. www.sciencedaily.com/releases/2017/02/170201092711.htm.

Study concludes: Grilled meat deadly for breast cancer survivors

Findings published in JNCI: Journal of the National Cancer Institute indicate that higher consumption of grilled, barbecued, and smoked meat may increase the mortality risk among breast cancer survivors. In the study, entitled “Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer,” Humberto Parada, Jr., MPH, and colleagues evaluated the link between grilled/barbecued and smoked meats and the survival time after breast cancer.

High-temperature cooked meat intake is a highly prevalent source of polycyclic aromatic hydrocarbons and other carcinogenic chemicals and has been associated with breast cancer incidence, but this study assessed whether intake is related to survival after breast cancer.

In a study population of 1508 Long Island women with breast cancer, subjects were interviewed and asked about their consumption of four types of grilled, barbecued, and smoked meat. The women were asked about their intake in each decade of life and were asked to specify the seasons in which the foods were most frequently consumed. At the five-year follow-up, participants responded to the same questions, which asked about the time period since the original questionnaire.

Findings include:

  • Among the 1508 case women, 597 deaths were identified, 237 (39.7%) of which were related to breast cancer, after a median duration of follow-up of 17.6 years.
  • Compared with low intake, high intake of grilled/barbecued and smoked meat prior to diagnosis was associated with a 23% increased hazard of all-cause mortality.
  • High vs low intake of smoked beef/lamb/pork intake was associated with a 17% increased hazard of all-cause and a 23% increased hazard of breast cancer-specific mortality.
  • Lifetime grilled/barbecued and smoked meat intake and prediagnosis annual intake of grilled/barbecued beef/lamb/pork and poultry/fish were not associated with mortality.
  • Compared with women with low prediagnosis and low postdiagnosis intake of grilled/barbecued and smoked meat, continued high intake was associated with a 31% increased hazard of all-cause mortality.
  • The increase in risk of death from any cause was similar in magnitude among women who reported high prediagnosis and low postdiagnosis intake of grilled/barbecued and smoked meat.

The study’s findings support the hypothesis that high consumption of grilled, barbecued, and smoked meat may increase mortality after breast cancer.


Story Source:

Materials provided by Oxford University Press USA. Note: Content may be edited for style and length.


Journal Reference:

  1. Humberto Parada, Susan E. Steck, Patrick T. Bradshaw, Lawrence S. Engel, Kathleen Conway, Susan L. Teitelbaum, Alfred I. Neugut, Regina M. Santella, Marilie D. Gammon. Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer. Journal of the National Cancer Institute, 2017; 109 (6): djw299 DOI: 10.1093/jnci/djw299

Read this article on ScienceDaily: https://www.sciencedaily.com/releases/2017/01/170105212820.htm

Women’s OB/GYN Medical Group of Santa Rosa Focuses on Cervical Health Awareness Month

Dr. Lela Emad offers hope for women concerned about cervical cancer risks, and shares important tips for staying healthy.

Healthy Women January is Cervical Health Awareness Month and there’s good news for the 13,000 women in the United States who are expected to be diagnosed with cervical cancer this year; early detection increases the 5-year survival rate for women with invasive cervical cancer (the worse-case scenario) by up to a whopping 92 percent. “To catch it early, a woman must get screened annually,” explains Dr. Lela Emad OB/GYN, “This is an important factor for the four out of five women who do not receive routine check-ups that includes a Pap Test.”

What is cervical cancer

At one time, cervical cancer was the most prominent cause of cancer death for American women. But, thanks to early detection and new treatment options developed over the last 40 years, the cervical cancer death rate has been cut in half. The real hero in this story is a simple test most women are very familiar with; the Pap test. This screening procedure makes it possible for healthcare professionals to catch minute changes in the cervix well before it has a chance to develop into cancer. Pap tests can also find cervical cancer early – when it is in its most curable stage – giving women with a positive diagnosis an even better chance of beating the disease.

The latest statistics from the American Cancer Society estimates that in the United States;

  • About 12,820 new cases of invasive cervical cancer will be diagnosed
  • About 4,210 women will die from cervical cancer

What causes cervical cancer?

The vast majority of both women and men will become infected with the Human papillomavirus or HPV at some point during their lifetimes and HPV is found in about 99 percent of cervical cancers cases. Although most HPV infections are benign and disappear on their own, some persist. Of the more than 100 different types of HPV most are considered low-risk and do not lead to cervical cancer. But some high-risk HPV strains persist to cause cervical cell abnormalities and go on to develop into cancer. The two types of the virus HPV-16 and HPV-18 are consider the most high-risk HPV strains.

Who gets cervical cancer

Most cases of cervical cancer are found in women between the ages of 20 and 50, and even women who have entered into menopause may still be at risk. About 20 percent of all cervical cancers are found in women over the age of 65. Cervical cancer rarely occurs in women who have received routine screenings for the disease during the years before they turned 65. In the United States, Hispanic women are most likely to get cervical cancer, followed by African-Americans, American Indians and Alaskan natives, and whites. Asians and Pacific Islanders have the lowest risk of cervical cancer in this country.

What is cervical cancer?

Cancer initiates in the body when otherwise normal cells begin to grow out of control, and it can affect any part of the body and even spread to other areas of the body. Cervical cancer begins in the cells lining the cervix — the lower part of the uterus (womb). Although cervical cancers start from cells in the pre-cancerous stages, only some of the women with pre-cancers of the cervix will go on to actually develop cancer. It normally takes a number of years before cervical pre-cancer turns into full blown cervical cancer, but it can happen in less time in some women. For most women, pre-cancerous cells resolve on their own without any treatment. But, treating all cervical pre-cancers can prevent almost all cervical cancers.

Symptoms of cervical cancer

Symptoms of the more advanced disease have been known to include abnormal or irregular vaginal bleeding, pain during sex, and/or unusual vaginal discharge. Abnormal bleeding symptoms outside of regular menstrual periods, after sexual intercourse or douching and bleeding after a pelvic exam can be symptoms of cervical cancer as can bleeding after menopause. Other symptoms include pelvic pain not related to the menstrual cycle, heavy or unusual discharge, increased urinary frequency and pain during urination. Of course, these symptoms could also be signs of other health problems not related to cervical cancer, but the best way to find out is to talk to a healthcare provider.

Prevention

Precancerous cervical cell changes and early cancers of the cervix generally do not cause any unusual symptoms. For this reason, routine screening through Pap and HPV tests is the best way to catch precancerous cell changes early, thereby preventing the development of cervical cancer.

“Pap test screening is obviously the first line of defense against cervical cancer,” says Dr. Emad. “We recommend Pap tests for women on a semi-annual basis after turning 21.” Regular gynecological Pap tests are the best way to detect most abnormal cell changes due to HPV well before they become cancer.

“Early detection of precancer cells makes it possible for a woman to be effectively treated before it becomes malignant, but unfortunately not every woman in committed to receive a regular Pap Test. This needs to become a priority for every woman, and particularly those who are intent on staying healthy.”

About Women’s OB/GYN Medical Group

Women’s OB/GYN Medical Group offers comprehensive testing with the latest available technology to screen for a full-spectrum of diseases and symptoms, and to monitor conditions as they develop in order to maximize patients’ health and well-being. The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Visit the website to learn more or call 707-579-1102 to schedule an appointment.

Dr. Susan Logan Recognized as Among the “Top Doctors” in the Bay Area by San Francisco Magazine

Susan Logan, M.D. of NCMA Women’s OB/GYN Medical Group has been selected by the San Francisco Magazine as among the top Obstetrics and Gynecology doctors for 2017.

San Francisco Magazine recently queried area doctors to nominate their choice of best physicians in eight Bay Area counties for 2017. Almost 1,000 nominations were submitted and a little over 500 physicians were selected by the healthcare research company managing the award process. Results were announced the magazine’s January 2017 issue.

Under the category of Obstetrics and Gynecology, Women’s OB/GYN Medical Groups physician Dr. Susan Logan has been selected for this honor by San Francisco Magazine for two years consecutively.

Dr. Lela Emad of the Women’s OB/GYN Medical Group says, “Dr. Susan C. Logan is a respected, caring OB/GYN certified by the American Board of Obstetrics and Gynecology. She has been a part of our group since the early 90s, and has played an integral role in building the practice. We are honored to have her among our providers and her patients are lucky to have someone so knowledgeable to deliver such quality caring support for their healthcare needs.”

Dr. Logan also serves as Antepartum Testing Medical Director at Santa Rosa Memorial Hospital, as well as the Medical Director of the Sweet Success Program.

About the Women’s OB/GYN Medical Group

With a team made up of compassionate, expert doctors, midwives, nurses and medical assistants aimed at providing unmatched care to patients, the Women’s OB/GYN Medical Group offers a full range of obstetrics and gynecology services to women in the North Bay region.  Services offered include;

  • general gynecological health screenings
  • state-of-the-art diagnostics
  • comprehensive pregnancy and postpartum care
  • full mid-wifery services
  • minimally invasive laparoscopic surgery
  • uro-gynecological procedures
  • incontinence care
  • menopause care
  • laser hair reduction, skin care and Botox Cosmetic

Women’s OB/GYN Medical Group’s staff of physicians include; Lela Emad, MD, Shazah Khawaja, MD, Amita Kachru, MD, and Susan Logan, MD. Together, these doctors share a unique whole-body approach to medicine as they strive to find the underlying causes of a woman’s health problems, rather than simply treating the symptoms.

The team of health professionals at Women’s OB/GYN is committed to both alleviating short-term ailments and maximizing long-term health. The practice partnered with Northern California Medical Associates (NCMA) in 2014 to strengthen its network of experienced healthcare providers, directly benefitting patient access to healthcare specialists in the area.

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.