OB/GYN News Articles

Can working nights increase a woman’s cancer risk?

Among female nurses alone, those who worked the night shift had an increased risk of breast (58 percent), gastrointestinal (35 percent), and lung cancer (28 percent) compared with those that did not work night shifts. Of all the occupations analyzed, nurses had the highest risk of developing breast cancer if they worked the night shift.

Researchers performed a meta-analysis using data from 61 articles comprising 114,628 cancer cases and 3,909,152 participants from North America, Europe, Australia, and Asia. The articles consisted of 26 cohort studies, 24 case-control studies, and 11 nested case-control studies. These studies were analyzed for an association between long-term night shift work and risk of 11 types of cancer. A further analysis was conducted, which looked specifically at long-term night shift work and risk of six types of cancer among female nurses.

Overall, long-term night shift work among women increased the risk of cancer by 19 percent. When analyzing specific cancers, the researchers found that this population had an increased risk of skin (41 percent), breast (32 percent), and gastrointestinal cancer (18 percent) compared with women who did not perform long-term night shift work. After stratifying the participants by location, researcher Xuelei Ma found that an increased risk of breast cancer was only found among female night shift workers in North America and Europe.

“We were surprised to see the association between night shift work and breast cancer risk only among women in North America and Europe,” said Ma. “It is possible that women in these locations have higher sex hormone levels, which have been positively associated with hormone-related cancers such as breast cancer.”

Among female nurses alone, those who worked the night shift had an increased risk of breast (58 percent), gastrointestinal (35 percent), and lung cancer (28 percent) compared with those that did not work night shifts. Of all the occupations analyzed, nurses had the highest risk of developing breast cancer if they worked the night shift.

“Nurses that worked the night shift were of a medical background and may have been more likely to undergo screening examinations,” noted Ma. “Another possible explanation for the increased cancer risk in this population may relate to the job requirements of night shift nursing, such as more intensive shifts.”

The researchers also performed a dose-response meta-analysis among breast cancer studies that involved three or more levels of exposure. They found that the risk of breast cancer increased by 3.3 percent for every five years of night shift work.

“By systematically integrating a multitude of previous data, we found that night shift work was positively associated with several common cancers in women,” said Ma. “The results of this research suggest the need for health protection programs for long-term female night shift workers.

“Our study indicates that night shift work serves as a risk factor for common cancers in women,” said Ma. “These results might help establish and implement effective measures to protect female night shifters. Long-term night shift workers should have regular physical examinations and cancer screenings.

“Given the expanding prevalence of shift work worldwide and the heavy public burden of cancers, we initiated this study to draw public attention to this issue so that more large cohort studies will be conducted to confirm these associations,” he added.

A limitation of this work is a lack of consistency between studies regarding the definition of “long-term” night shift work, with definitions including “working during the night” and “working at least three nights per month.” Additional limitations include significant between-study heterogeneity and publication bias.


Read this article on ScienceDaily: American Association for Cancer Research. “Female night shift workers may have increased risk of common cancers.” ScienceDaily. ScienceDaily, 8 January 2018. www.sciencedaily.com/releases/2018/01/180108090118.htm.

New study reveals: Women Really are Better Survivors

Women survive crises better than men Newborn girls are hardier than newborn boys during famines, epidemics
Women today tend to live longer than men almost everywhere worldwide — in some countries by more than a decade. Now, three centuries of historical records show that women don’t just outlive men in normal times: They’re also more likely to survive even in the worst of circumstances, such as famines and epidemics.
Women today tend to live longer than men almost everywhere worldwide — in some countries by more than a decade.

Now, three centuries of historical records show that women don’t just outlive men in normal times: They’re more likely to survive even in the worst of circumstances, such as famines and epidemics, researchers report.

Most of the life expectancy gender gap was due to a female survival advantage in infancy rather than adulthood, the researchers found. In times of adversity, newborn girls are more likely to survive.

The fact that women have an edge in infancy, when behavioral differences between the sexes are minimal, supports the idea that explanation is at least partly biological, the researchers say.

Led by Virginia Zarulli, an assistant professor at the University of Southern Denmark, and James Vaupel, a research professor at Duke University, the team analyzed mortality data going back roughly 250 years for people whose lives were cut short by famine, disease or other misfortunes.

The data spanned seven populations in which the life expectancy for one or both sexes was a dismal 20 years or less. Among them were working and former slaves in Trinidad and the United States in the early 1800s, famine victims in Sweden, Ireland and the Ukraine in the 18th, 19th and 20th centuries, and Icelanders affected by the 1846 and 1882 measles epidemics.

In Liberia, for example, freed American slaves who relocated to the West African country in the 1800s experienced the highest mortality rates ever recorded. More than 40 percent died during their first year, presumably wiped out by tropical diseases they had little resistance to. Babies born during that time rarely made it past their second birthday.

Another group of people living in Ireland in the 1840s famously starved when a potato blight caused widespread crop failure. Life expectancy plummeted by more than 15 years.

Overall the researchers discovered that, even when mortality was very high for both sexes, women still lived longer than men by six months to almost four years on average.

Girls born during the famine that struck Ukraine in 1933, for example, lived to 10.85, and boys to 7.3 — a 50 percent difference.

When the researchers broke the results down by age group, they found that most of the female survival advantage comes from differences in infant mortality. Newborn girls are hardier than newborn boys.

The results suggest that the life expectancy gender gap can’t be fully explained by behavioral and social differences between the sexes, such as risk-taking or violence.

Instead, the female advantage in times of crisis may be largely due to biological factors such as genetics or hormones. Estrogens, for example, have been shown to enhance the body’s immune defenses against infectious disease.

“Our results add another piece to the puzzle of gender differences in survival,” the researchers said.

The findings were published Jan. 8, 2018, in the early online edition of Proceedings of the National Academy of Sciences.


Read this article on Science Daily:

Duke University. “Women survive crises better than men: Newborn girls are hardier than newborn boys during famines, epidemics.” ScienceDaily. ScienceDaily, 9 January 2018. <www.sciencedaily.com/releases/2018/01/180109105941.htm>.

Researchers use MRI for the first time ever in effort to decode early labor

Scientists are using the latest imaging techniques usually used to map the brain to try and understand why some pregnant women miscarry or go into early labor.
Scientists are using the latest imaging techniques usually used to map the brain to try and understand why some pregnant women miscarry or go into early labor.

They have developed 3D images of the cervix, the load bearing organ which lies at the base of the womb and stops a developing baby from descending into the birth canal before the due date.

Around a quarter of miscarriages during the fourth to sixth month of pregnancy (mid-trimester) occur because of weaknesses in the cervix.

The researchers at the University of Leeds hope by developing a detailed image of its structure, they can develop ways of monitoring women for signs of potential problems before they become pregnant.

Mr Nigel Simpson, Associate Professor in Obstetrics and Gynaecology, said: “Ultrasound monitoring is used to identify women at risk — where their cervix is unable to support the pregnancy. But little is known about why that problem develops.

“This research is attempting to answer that question.”

MRI techniques were used to create 3D images of the cervix. This is the first time extremely high resolution imaging has been used to understand the detailed micro-structure of this organ.

The research is published in the international obstetrics and gynaecology journal, BJOG.

James Nott, from the Faculty of Medicine and Health and lead author, said: “A lot of our understanding of the biology of the cervix is rooted in research carried out 50 years ago.

“By applying the imaging techniques that have been used on the brain, we can get a much clearer understanding of the tissue architecture that gives the cervix its unique biomechanical properties.”

The images reveal a fibrous structure running along the upper part of the cervix. The fibres are much more pronounced near to where it joins the womb. The fibres are made of collagen and smooth muscle and form a ring around the upper aspect of the cervical canal.

During pregnancy, these fibres provide a strong supporting barrier — keeping the fetus and amniotic sac in place and preventing micro-organisms from entering the uterus.

The images reveal that these support tissues are less prominent further down the cervix as it joins the birth canal.

During labour, the body releases chemicals which result in the cervix opening and allowing the baby to enter the birth canal.

But there are medical conditions where earlier in the pregnancy, the cervix fails to support the baby, leading to a miscarriage or premature birth.

Mr Simpson said: “This study’s findings have encouraged us to explore new imaging techniques to check the integrity of these fibres before or during pregnancy in order to identify at-risk mums, intervene earlier, and so prevent late pregnancy loss and pre-term birth.”

The study was funded by Cerebra, the charity for children with brain conditions.

The scientists used diffusion tensor MRI, which is a technology that can remotely sense different types of tissue based on their water content.


Story Source:

Materials provided by University of Leeds. Note: Content may be edited for style and length.


Journal Reference:

  1. JP Nott, E Pervolaraki, AP Benson, EA Bonney, JD Pickering, N Wilkinson, NAB Simpson. Diffusion tensor imaging determines three-dimensional architecture of human cervix: a cross-sectional study. BJOG: An International Journal of Obstetrics & Gynaecology, 2017; DOI: 10.1111/1471-0528.15002

Read this article on ScienceDaily, 20 December 2017. www.sciencedaily.com/releases/2017/12/171220121758.htm.

Start the New Year Right: Quit the nicotine habit using the latest research model for success

In addition to lowering the effects of nicotine withdrawal, exercise is by far the best thing women can do to improve health.The Women’s OB/GYN Medical Group shares insight into how women who have a nicotine habit can take advantage of the latest research trends for quitting that might just guarantee success; starting an exercise routine.

Smoking is a bad habit for anyone and for women it poses very specific problems, particularly for pregnant women and women who are considering pregnancy. “Now is the perfect time for women of all ages to make a commitment to stop smoking,” says Dr. Lela Emad Obstetrician & Gynecologist. “In light of the latest research, we’re asking all of our patients who smoke or use nicotine products, to make the commitment to change this one lifestyle habit, and start the New Year on a better track toward health.”

The Study 

Experts at St George’s University of London set out to understand the underlying mechanism that seems to be exercise’s way of supporting the body against nicotine dependence and withdrawal. The study revealed that even moderate exercise noticeably reduces the severity of nicotine withdrawal symptoms. The findings help to validate the protective effect of exercise during smoking cessation; against the development of physical dependence, which may help smokers in giving up the habit by reducing the severity of withdrawal symptoms.

The Impact of Smoking

According to the Center of Disease Control and Prevention cigarette smoking remains the leading cause of preventable death and disability in the United States, despite a significant decline in the number of people who smoke. More than 16 million Americans have at least one disease caused by smoking.

“If exercise works to decrease the symptoms associated with nicotine withdrawal, then taking up an exercise routine and quitting the habit go hand in hand,” Dr. Emad says. “Statistics show that only 30 percent of women quit smoking when they find out they are pregnant, if we could make a dent in that number, it will have a positive impact on the well-being of both mothers and their children.”

Cigarette smoking alone kills more than 480,000 Americans each year. It causes direct damage to the body, which can lead to long-term health problems. We’ve all heard that smoking causes cancer, lung and heart disease, and stroke, but smoking also causes specific problems for women’s health including:

  • Decreased bone density
  • Rheumatoid arthritis
  • Cataracts
  • Gum disease
  • Ulcers
  • Depression
  • Menstrual problems
  • Low birth-weight
  • Pre-term delivery

In addition to lowering the effects of nicotine withdrawal, exercise is by far the best thing women can do to improve health. Exercise has been found to increase a person’s overall energy level and it releases endorphins—which in turn increases a person’s happiness quotient. Ongoing research suggests that as little as 2.5 hours weekly (about 20 minutes a day) of moderate aerobic exercise such as walking provides all the major health benefits a body needs to stay healthy.

“What a great resolution for women of all ages to make for this New Year; stop smoking, start exercising,” Dr. Emad said.

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information call (707) 579-1102 or visit the Women’s OB/GYN website.

Discontinuance of Hormone Therapy May Be Hazardous to the Heart

A new study demonstrates that the risk of cardiac and stroke death actually increases in the first year after discontinuation of HT.
Hormone therapy (HT) continues to be a hotly debated topic. The benefits of estrogen to the heart, however, appear to be universally accepted. A new study demonstrates that the risk of cardiac and stroke death actually increases in the first year after discontinuation of HT. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Since publication of the Women’s Health Initiative (WHI) clinical trial data, there has been significant disagreement over the various risks and benefits of HT. What remains relatively unchallenged is the fact that estrogen has rapid beneficial vascular effects and that shorter periods between the onset of menopause and the initiation of HT provide greater protection against cardiovascular disease. This beneficial relationship between HT and protection against heart disease has led to the speculation that withdrawal from HT could result in clinically significant changes in arterial function. Although previous studies have shown that termination of estradiol-based HT led to significant increases in the risk of cardiac and stroke deaths, particularly during the first year, these results were questioned because women with documented heart problems had not been excluded from the study.

This study, however, involving more than 400,000 Finnish women excluded women with prior cardiac or stroke events. The results of the study, published in the article “Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy,” showed that discontinuation of HT was associated with an increased risk of cardiac and stroke death during the first posttreatment year, especially in women who discontinued HT aged younger than 60 years. This increased risk was not observed in women aged 60 years or older at the time of discontinuation.

“Since the initial Women’s Health Initiative reports, studies have shown that hormone therapy has many benefits and is safer than originally thought. This is especially true for symptomatic menopausal women younger than age 60 and within 10 years of menopause, as these women had fewer heart events and less risk of mortality,” says Dr. JoAnn Pinkerton, NAMS executive director. “This new study suggests that younger women may have a higher risk of heart disease and stroke during the first year of discontinuation. Thus, women and their healthcare providers need to consider the benefits and risks of starting and stopping hormone therapy before making any decisions.”


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.com: The North American Menopause Society (NAMS). “Risk of cardiac and stroke death increases after discontinuing hormone therapy: Highest risk occurs in first year after discontinuation, especially in women aged younger than 60 years.” ScienceDaily. ScienceDaily, 8 November 2017. www.sciencedaily.com/releases/2017/11/171108124156.htm.

Fewer Cesarean Deliveries Associated with Midwife-Attended Hospital Births

Women who gave birth at hospitals with a larger percentage of midwife-attended births were less likely to have two specific medical interventions, cesarean delivery and episiotomy, a new, hospital-level analysis. These findings raise the possibility that greater access to midwifery care, which is low in the United States, might enhance perinatal care and lower costs for low-risk women.

In a new, hospital-level analysis by health policy researcher Laura Attanasio at the University of Massachusetts Amherst and Katy Kozhimannnil at the University of Minnesota School of Public Health, they report that women who gave birth at hospitals that had a larger percentage of midwife-attended births were less likely to have two specific medical interventions, cesarean delivery and episiotomy.

Attanasio, an assistant professor of health policy and management at UMass Amherst’s School of Public Health and Health Sciences, explains that a growing body of research at the individual level has shown that compared to women cared for by physicians, women considered at low-risk for complications in childbirth who receive care from midwives have good outcomes that include lower use of interventions such as cesarean delivery.

The researchers analyzed hospital-level data reported in New York State over one year. Details appear in the current Journal of Midwifery & Women’s Health. Their study analyzes the experiences of individual women; an accompanying policy brief looks at hospital rates of medical interventions at the time of childbirth.

The authors say their findings raise the possibility that greater access to midwifery care, which is low in the United States, might enhance perinatal care and lower costs for low-risk women. In 2014, the year of the study, Attanasio and Kozhimannil point out that midwives attended just 9 percent of U.S. births, compared to more than 66 percent in other western countries such as Australia, France and the U.K.

They add, “More midwife-attended births may be correlated with fewer obstetric procedures, which could lower costs without lowering the quality of care. This raises the possibility of improving value in maternity care through greater access to midwifery care for childbearing women in the United States.”

The researchers used the Healthcare Cost and Utilization Project State Inpatient Database data for New York and New York State Department of Health data on the percentage of midwife-attended births at hospitals in the state in 2014 to estimate the association between the hospital-level percentage of midwife-attended births and four outcomes among low-risk women: induced labor, cesarean delivery, episiotomy and severe obstetric morbidity — that is, unintended outcomes of labor or delivery that have significant negative effects on the mother’s health.

Of the 126 hospitals included, the researchers say, about 25 percent of the hospitals had no midwives present. About 50 percent had some midwives present, but they attended less than 15 percent of births, while at 7 percent of the hospitals, midwives attended over 40 percent of births. They controlled for such variables as mother’s age, insurance type, and diagnosis of diabetes and hypertension.

Key findings were:

  • Women who gave birth at hospitals with more midwife-attended births had lower odds of delivering by cesarean and lower odds of episiotomy.
  • Hospital-level percentage of midwife-attended births was not associated with changes in labor induction or severe obstetric morbidity.

Attanasio says, “This study is contributing to a body of research which shows that good outcomes for women at low risk in childbirth go hand-in-hand with lower use of medical procedures. And, there is increasing attention now to overuse of cesarean and other procedures that are not resulting in better outcomes for mom and baby.”

Kozhimannil adds that the findings imply that a greater midwifery presence may have important clinical benefits. “From a policy perspective, this study should encourage legislators and regulators to consider efforts to safely expand access to midwifery care for low-risk pregnancies,” she notes.

Several states are considering expanding midwives’ scope of practice as New York State did in 2010 for certified nurse midwives, Attanasio says. “I hope that this work contributes to the evidence related to promoting the quality and value in maternity care that midwives can bring. A number of studies have shown that expanding their scope of practice and giving midwives more autonomy can increase women’s access to midwifery care.”


Story Source:

Materials provided by University of Massachusetts at Amherst. Note: Content may be edited for style and length.


Journal Reference:

  1. Laura Attanasio, Katy B. Kozhimannil. Relationship Between Hospital-Level Percentage of Midwife-Attended Births and Obstetric Procedure Utilization. Journal of Midwifery & Women’s Health, 2017; DOI: 10.1111/jmwh.12702

Read this article on ScienceDaily: University of Massachusetts at Amherst. “Midwifery care at hospitals is associated with fewer medical interventions.” ScienceDaily. ScienceDaily, 16 November 2017. www.sciencedaily.com/releases/2017/11/171116132736.htm.

Pesticide residue on produce may affect fertility


Eating more fruits and vegetables with high-pesticide residue was associated with a lower probability of pregnancy and live birth following infertility treatment for women using assisted reproductive technologies, report researchers.
The JAMA Network Journals reports that eating more fruits and vegetables with high-pesticide residue was associated with a lower probability of pregnancy and live birth following infertility treatment for women using assisted reproductive technologies, report researchers.
Is preconception intake of fruits and vegetables with pesticide residues associated with outcomes of assisted reproductive technologies?

Animal studies suggest ingestion of pesticide mixtures in early pregnancy may be associated with decreased live-born offspring leading to concerns that levels of pesticide residues permitted in food by the U.S. Environmental Protection Agency may still be too high for pregnant women and infants.

325 women who completed a diet questionnaire and subsequently underwent cycles of assisted reproductive technologies as part of the Environment and Reproductive Health (EARTH) study at a fertility center at a teaching hospital in Boston between 2007 and 2016 by Jorge E. Chavarro, M.D., Sc.D., of the Harvard T. H. Chan School of Public Health, Boston, and colleagues.

Researchers categorized fruits and vegetables as having high or low pesticide residues using a method based on surveillance data from the U.S. Department of Agriculture. They counted the number of confirmed pregnancies and live births per cycle of fertility treatment.

This is an observational study. In observational studies, researchers observe exposures and outcomes for patients as they occur naturally in clinical care or real life. Because researchers are not intervening for purposes of the study they cannot control natural differences that could explain study findings so they cannot prove a cause-and-effect relationship.

Results of the study indicate that eating more high-pesticide residue fruits and vegetables (for example, strawberries and raw spinach) was associated with a lower probability of pregnancy and live birth following infertility treatment. Eating more low-pesticide residue fruits and vegetables was not associated with worse pregnancy and live birth outcomes.

Limitations of the study include that the study estimated exposure to pesticides based on women’s self-reported intake combined with pesticide residue surveillance data rather than through direct measurement. The study also cannot link specific pesticides to adverse effects.

“In conclusion, intake of high-residue FVs [fruits and vegetables] was associated with lower probabilities of clinical pregnancy and live birth among women undergoing infertility treatment. Our findings are consistent with animal studies showing that low-dose pesticide ingestion may exert an adverse impact on sustaining pregnancy. Because, to our knowledge, this is the first report of this relationship to humans, confirmation of these findings is warranted.”


Story Source:Materials provided by The JAMA Network Journals. Note: Content may be edited for style and length.


Journal Reference:

  1. Yu-Han Chiu, Paige L. Williams, Matthew W. Gillman, Audrey J. Gaskins, Lidia Mínguez-Alarcón, Irene Souter, Thomas L. Toth, Jennifer B. Ford, Russ Hauser, Jorge E. Chavarro. Association Between Pesticide Residue Intake From Consumption of Fruits and Vegetables and Pregnancy Outcomes Among Women Undergoing Infertility Treatment With Assisted Reproductive Technology. JAMA Internal Medicine, 2017; DOI: 10.1001/jamainternmed.2017.5038

Read this article on sciencedaily.com www.sciencedaily.com/releases/2017/10/171030112401.htm

Dr. Melissa Seeker joins The Women’s OB/GYN Medical Group of Santa Rosa

Dr. Melissa A. Seeker joins the Women’s OB/GYN Medical Group to become part of a unique team of highly skilled healthcare professionals.

Dr. Melissa A. Seeker has joined Santa Rosa’s preeminent Women’s OB/GYN Medical Group. She is an alumnus of Saint Louis University where she graduated as a member of Alpha Sigma Nu with honors prior to receiving her MD at Creighton University School of Medicine. She served as Chief Resident in Obstetrics and Gynecology at the University Of Arizona College Of Medicine – Phoenix, formerly Banner University Medical Center, where she underwent her residency training.

Dr. Seeker holds many awards and honors in her specialty of Obstetrics and Gynecology including the Award for Excellence in Female Pelvic Medicine and Reconstructive Surgery from the University Of Arizona College Of Medicine – Phoenix. During her medical training, she spent six weeks in the Philippines, Malaysia, and Indonesia providing care to over 3,500 patients with a small medical team. Her resident research project in minimally invasive surgery was selected for presentation at the Society for Gynecologic Surgeons Annual Scientific Meeting. Dr. Seeker also received advanced certification in integrative medicine after completing an elective course from The University of Arizona Center for Integrative Medicine.

Dr. Seeker has special interest in pregnancy education and has volunteered her services to worthy organizations and outreaches specializing in gynecologic care. She is happily married and the proud owner of two boxer dogs and one cat. Outside of medicine, she enjoys traveling, scuba diving, camping, hiking, cooking, and enjoying the great outdoors.

“We are delighted to welcome Melissa to our growing practice,” says Dr. Lela Emad M.D. “Dr. Seeker is a talented and caring physician whose expertise will enhance our services to women in very positive ways.”

About the Women’s OB/GYN Medical Group

As recognized leaders in their field the Women’s OB/GYN Medical Group has offered a full range of premier obstetrics and gynecology services and expertise to women in the North Bay area for more than 25 years. The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in the Santa Rosa region. As women proudly serving women, this unique group understands patient needs and expectations like no other.

Along with Dr. Seeker, the Women’s OB/GYN Medical Group’s staff of physicians includes; Lela Emad, MD, Shazah Khawaja, M.D., Amita Kachru, M.D.,  Susan Logan, M.D. and Tara Bartlett M.D. Together, these doctors share a unique whole-body approach to medicine as they work to discover the underlying causes of a woman’s health problems, rather than simply treating the symptoms. Every one of the health professionals at Women’s OB/GYN is committed to both alleviating short-term ailments and maximizing long-term health.

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. To schedule an appointment with Dr. Seeker, please call: (707) 579-1102.

How do women stay heart healthy? Go bananas!

Bananas and avocados -- foods that are rich in potassium -- may help protect against pathogenic vascular calcification, also known as hardening of the arteries.

Bananas and avocados — foods that are rich in potassium — may help protect against pathogenic vascular calcification, also known as hardening of the arteries.

University of Alabama at Birmingham researchers have shown, for the first time, that reduced dietary potassium promotes elevated aortic stiffness in a mouse model, as compared with normal-potassium-fed mice. Such arterial stiffness in humans is predictive of heart disease and death from heart disease, and it represents an important health problem for the nation as a whole.

The UAB researchers also found that increased dietary potassium levels lessened vascular calcification and aortic stiffness. Furthermore, they unraveled the molecular mechanism underlying the effects of low or high dietary potassium.

Such knowledge of how vascular smooth muscle cells in the arteries regulate vascular calcification emphasizes the need to consider dietary intake of potassium in the prevention of vascular complications of atherosclerosis. It also provides new targets for potential therapies to prevent or treat atherosclerotic vascular calcification and arterial stiffness.

A UAB team led by Yabing Chen, Ph.D., UAB professor of pathology and a Research Career Scientist at the Birmingham VA Medical Center, explored this mechanism of vascular disease three ways: living mice fed diets that varied in potassium, mouse artery cross-sections studied in culture medium with varying concentrations of potassium, and mouse vascular smooth muscle cells grown in culture medium.

Working from living mice down to molecular events in cells in culture, the UAB researchers determined a causative link between reduced dietary potassium and vascular calcification in atherosclerosis, as well as uncovered the underlying pathogenic mechanisms.

The animal work was carried out in the atherosclerosis-prone mouse model, the apoliprotein E-deficient mice, a standard model that are prone to cardiovascular disease when fed a high-fat diet. Using low, normal or high levels of dietary potassium — 0.3 percent, 0.7 percent and 2.1 percent weight/weight, respectively, the UAB team found that the mice fed a low-potassium diet had a significant increase in vascular calcification. In contrast, the mice fed a high-potassium diet had markedly inhibited vascular calcification. Also, the low-potassium mice had increased stiffness of their aortas, and high-potassium mice had decreased stiffness, as indicated by the arterial stiffness indicator called pulse wave velocity, which is measured by echocardiography in live animals.

The different levels of dietary potassium were mirrored by different blood levels of potassium in the three groups of mice.

When researchers looked at arterial cross-sections in cultures that were exposed to three different concentrations of potassium, based on normal physiological levels of potassium in the blood, they found a direct effect for the potassium on arterial calcification within arterial rings. Arterial rings in low-potassium had markedly enhanced calcification, while high-potassium inhibited aortic calcification.

“The findings have important translational potential,” said Paul Sanders, M.D., professor of nephrology in the UAB Department of Medicine and a co-author, “since they demonstrate the benefit of adequate potassium supplementation on prevention of vascular calcification in atherosclerosis-prone mice, and the adverse effect of low potassium intake.”

Mechanistic details

In cell culture, low potassium levels in the culture media markedly enhanced calcification of vascular smooth muscle cells. Previous research by several labs including Chen’s group has shown that calcification of vascular smooth muscle cells resembles the differentiation of bone cells, which leads to the transformation of smooth muscle cells into bone-like cells.

So the UAB researchers tested the effect of growing vascular smooth muscle cells in low-potassium cell culture. They found that the low-potassium conditions promoted the expression of several gene markers that are hallmarks of bone cells, but decreased the expression of vascular smooth muscle cell markers, suggesting the transformation of the vascular smooth muscle cells into bone-like cells under low-potassium conditions.

Mechanistically, they found that low-potassium elevated intracellular calcium in the vascular smooth muscle cells, via a potassium transport channel called the inward rectifier potassium channel. This was accompanied by activation of several known downstream mediators, including protein kinase C and the calcium-activated cAMP response element-binding protein, or CREB.

In turn, CREB activation increased autophagy — the intracellular degradation system — in the low-potassium cells. Using autophagy inhibitors, the researchers showed that blocking autophagy blocked calcification. Thus, autophagy plays an important role in mediating calcification of vascular smooth muscle cells induced by the low-potassium condition.

The roles of the CREB activation and autophagy signals were then tested in the mouse artery cross-section and living-mouse models, with low, normal or high levels of potassium in the media or diet. Results in both of those systems supported the vital role for potassium to regulate vascular calcification through calcium signaling, CREB and autophagy.

Besides Chen and Sanders, co-authors of the paper, “Dietary potassium regulates vascular calcification and arterial stiffness,” published in JCI Insight, are Yong Sun, Chang Hyun Byon and Youfeng Yang, UAB Department of Pathology; Wayne E. Bradley, Louis J. Dell’Italia and Anupam Agarwal, UAB Department of Medicine; and Hui Wu, UAB Department of Pediatric Dentistry. Sanders, Agarwal and Chen are also members of the Research Department, Veterans Affairs Birmingham Medical Center.


Story Source:

Materials provided by University of Alabama at Birmingham. Note: Content may be edited for style and length.


Journal Reference:

  1. Yong Sun, Chang Hyun Byon, Youfeng Yang, Wayne E. Bradley, Louis J. Dell’Italia, Paul W. Sanders, Anupam Agarwal, Hui Wu, Yabing Chen. Dietary potassium regulates vascular calcification and arterial stiffness. JCI Insight, 2017; 2 (19) DOI: 10.1172/jci.insight.94920

Read this article on ScienceDaily. ScienceDaily, 5 October 2017. www.sciencedaily.com/releases/2017/10/171005102712.htm.

Healthy Lifestyle Choices to Ensure a Lifetime of Breast Health

In this article Dr. Shazah Khawaja MD  of the Women’s OB/GYN Medical Group of Santa Rosa focuses on empowering women for Breast Cancer Awareness month by highlighting breast cancer prevention strategies.

We believe that when a woman understands the facts about breast cancer she becomes empowered to take the necessary steps towards prevention. Breast health.During October’s National Breast Cancer Awareness Campaign, The Women’s OB/GYN Medical Group is focusing on empowerment through knowledge leading to healthy choices. “We believe that when a woman understands the facts about breast cancer she becomes empowered to take the necessary steps towards prevention. By working to detect the disease in its early stages, a woman is able to make lifestyle changes to reduce the odds of developing the disease in the first place,” explains Dr. Shazah Khawaja, MD, Obstetrician & Gynecologist.

Despite decades of pursing an all-out cure and national efforts aimed at education and prevention, breast cancer remains the most common cancer among women in the United States, second only to skin cancer. Today millions of women are surviving the disease, thanks in part to early detection, improvements in treatment and by enacting healthy lifestyle choices.

The First Step in Staying Healthy

Experts agree that the key to not only surviving a breast cancer diagnosis, but to thriving for years afterwards is early detection followed by early treatment. Routine breast exams and general awareness of how to maintain breast health are both important elements in staying healthy. Practitioners at the Women’s OB/GYN Medical Group encourage routine screening including regular self-breast exams, breast checks during annual gynecologic exams, and screening mammography – all approaches that help to detect breast problems early-on.  “I routinely tell my patients that when we have the opportunity to catch and treat breast problems early, we have a better shot of ensuring the treatment will be successful,” says Dr. Khawaja.

Understanding Breast Cancer Risks for Better Outcomes

Although a having a higher risk for developing the disease may be frightening, it is also true that women who have one or more risk factors for developing breast cancer, never actually develop the disease. With increased awareness about the risk associated with certain factors – particularly those that revolve around lifestyle choices that can be changed – women of all risk levels can become empowered to make better choices.

Some risk factors such as age, genetics or race obviously cannot be changed. Other factors including environment, can also be difficult to modify. While some factors influence risk more than others, a person’s risk for developing breast cancer can change naturally due to aging and by making certain changes in habits and daily practices.

According to the American Cancer Society there are several factors that can affect a woman’s breast cancer risks including:

  • Having children after age 30 (shown to increase the risk of breast cancer in some cases).
  • Birth Control (oral and injectable contraceptives stand out in studies as contributors to breast cancer).
  • Alcohol consumption (the more consumed, the higher the risk).
  • Weight (women who carry extra pounds have a higher risk for developing breast cancer, primarily due to the higher insulin levels that accompany obesity).
  • Smoking (evidence suggests a link between smoking and breast cancer risk, particularly in premenopausal women).

Known Factors that Lower Risk:

Researchers continue to pursue the link between diet and breast cancer risk and many studies actually indicate that diet does play a role. More and more studies cast a wary eye towards red meat consumption, and there is an increased risk associated with high-fat diets, which perpetuates weight gain and obesity (a known breast cancer risk factor).

There may be sure way to prevent breast cancer as of yet, but there are things women can do to help lower the risk. A short list of actions includes;

  • Breast Feeding – for women who breast feed for 1.5 to 2 years studies suggest that there may be some benefit in reducing breast cancer risk
  • Physical Activity – a growing body of evidence indicates that a person’s risk of developing almost any cancer, particularly breast cancer is reduced by adopting a daily routine of physical activity. For example, as little as 1.25 hours of moderate physical activity per week may reduce the risk by up to 18 percent according to some studies.
  • Limit dose and duration of hormone therapy – Combination hormone therapy for more than five years is known to increase the risk of breast cancer. If you and your healthcare provider decide that the benefits of short-term hormone therapy outweigh the risks, use the lowest dose possible.

How OB/GYN Providers Can Help

Self-check breast exams are easy to perform in the home and should be conducted monthly in addition to annual breast exams with a physician at Women’s OB/GYN Medical Group. Depending on a patient’s age and individual health, we may recommend a more frequent interval of regular check-ups with a health care provider. And of course, if you suspect a breast health problem contact a provider immediately.

About the Women’s OB/GYN Medical Group

Women’s OB/GYN Medical Group’s staff of physicians include; Lela Emad, MD, Shazah Khawaja, MD, Amita Kachru, MD, and Susan Logan, MD along with two new providers; Tara Bartlett, D.O and Melissa A. Seeker, M.D. 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 expanded team of health professionals including Certified Nurse-Midwifes and Nurse Practitioners is committed to both alleviating short-term ailments and maximizing long-term health. 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 visit our website or to call for an appointment dial (707) 579-1102.