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Women’s health services are dedicated to treating women’s unique biological and physiological needs. Obstetrics, gynecology and family planning are areas of focus in women’s health. Women’s services cover a wide range of services, from annual procedures like PAP tests, to mammograms, urinary tract care, menopause, birth plans and delivery. The leading causes of death in women are heart disease, cancer and stroke. Other major health conditions women suffer from are diabetes, Alzheimer’s disease and chronic lower respiratory diseases. Healthy lifestyle choices, such as eating healthy and physical activity, reduce women’s health risks.
Women can find a full continuum of mother and baby care at the South Texas Medical Center. Our institutions offer state-of-the-art labor and delivery rooms designed with women and children in mind. Additional women’s services available at our institutions include breast cancer diagnoses and treatment, pregnancy testing, mammograms and all the non-invasive procedures performed using daVinci Gynecologic Surgery systems. Robotically assisted gynecologic surgeries include, but are not limited to, the treatment for cervical and uterine cancer, uterine fibroids, endometriosis, uterine prolapse and menorrhaiga or excessive bleeding.
Institutions at the South Texas Medical Center offering women services take a family-centered approach to maternity care and offer a comprehensive range of obstetrical and gynecological services. Our institutions are also equipped with neonatal intensive care units to care for mothers experiencing special or high-risk deliveries.
Women’s Health Articles
Walking, biking and taking public transit tied to lower weight
By Andrew M. Seaman
NEW YORK (Reuters Health) - People who walk, bike or take public transportation to work tend to be thinner than those who ride in their own cars, according to a new study from the UK.
The new findings - including that taking public transportation was just as beneficial as the other "active commuting" modes - point to significant health benefits across society if more people left their cars at home, researchers say.
"It seems to suggest switching your commute mode - where you can build in just a bit of incidental physical activity - you may be able to cut down on your chance of being overweight and achieve a healthier body composition as well," said Ellen Flint, who led the study.
Flint and her colleagues from London School of Hygiene and Tropical Medicine and University College London write at TheBMJ.com that physical activity has decreased along with the proportion of people taking active modes of transportation to work.
There is also evidence to suggest greater increases in obesity rates in areas with larger declines in active travel, they add.
Active travel or commuting typically refers to walking or biking to work, but Flint and her colleagues suggest the term should be expanded to include taking public transportation, such as buses and trains.
In their study, Flint said, they found people who reported walking to work weren't walking far - about a mile or less.
"The walking that goes into commuting to public transport is a similar amount," she told Reuters Health.
While there is evidence to support a link between walking and biking to work and reduced weight, there is little research that also looks at people who take public transportation.
For the new study, Flint and her colleagues used data collected from a national sample of people living in the UK who answered survey questions and were visited by a nurse. The researchers had data from 7,424 people on how much body fat they had and from 7,534 on their body mass index (BMI), a measure of weight relative to height.
In the survey, 76 percent of men and 72 percent of women reported taking a private mode of transportation - usually a car - to work. Ten percent of men and 11 percent of women reported using mostly public transportation and 14 percent of men and 17 percent of women walked or biked to work.
After adjusting for traits or behaviors that may influence weight or body fat, such as socioeconomic status and other exercise, the researchers found that people who walked, biked or took public transportation to work had lower average BMIs and body fat percentages than people who used private transportation.
"When you compare public transport to private transport the results are pretty similar to when you compare active transport to private transport," Flint said.
She and her colleagues write that the differences in body mass and fat would be noticeable. For example, men who actively commuted to work or took public transportation had a BMI score between 0.9 and 1.1 points lower than the men who drove themselves. That can be the equivalent of weighing about seven pounds less for a middle aged man of average height.
The men's body fat was also between 1.4 and 1.5 percentage points lower among active and public transport commuters, compared to men who drove.
Similar results were seen for women, whose BMI scores were between 0.7 and 0.9 points lower among active and public commuters compared to women who drove. For a 5-foot 4-inch woman the difference would translate to about 6 lbs.
Amy Auchincloss of Drexel University in Philadelphia said the study's results are strong because its data are from people living in many different areas, although the findings can't prove that walking, biking or taking public transportation causes people to lose weight.
"But at minimum it appears from these preliminary data that not driving/not using automobiles will at least aide populations in healthier weight maintenance - if not directly lead to healthier weight," Auchincloss, who was not involved with the new study, said in an email.
Other studies have also suggested that a more active commute to work has a variety of benefits, according to Anthony Laverty, who co-wrote an editorial accompanying the new study.
"This study focuses on weight," he said. "There are other studies that show people who don't drive to work are less likely to have high blood pressure and diabetes."
"If we had this big shift of people taking public transport, walking or cycling you would have these benefits add up," said Laverty, of Imperial College London.
With obesity prevention already a focus of policymakers, Flint said working on getting more people to walk, bike or take public transportation may be worthwhile.
"In Britain - in common with a lot of industrial nations - the vast majority of commuters use cars. Therefore there is a huge potential for an intervention of access to public transportation for health benefit," she said.
SOURCE: http://bit.ly/YuljgS TheBMJ, online August 19, 2014.
Preventable hospital deaths after urological surgery rising: study
By Kathryn Doyle
NEW YORK (Reuters Health) - As more urological surgeries are performed outside hospitals, deaths from preventable complications among men and women getting inpatient surgery have risen, according to a new study.
It's likely that older, sicker and poorer people make up more of the population having inpatient surgery, not that the surgeries are getting more dangerous, researchers say.
"Our present findings provide evidence of a major shift in the type of patients being admitted for urological surgery," lead author Dr. Jesse Sammon told Reuters Health. "Historically, a much larger proportion of relatively healthy urology patients were admitted for low-risk procedures."
Sammon, a urologist at the VUI Center for Outcomes Research, Analytics and Evaluation at Henry Ford Health System in Detroit, and his coauthors used data on all hospital discharges of patients undergoing low-risk surgeries like transurethral resection of the prostate and bladder biopsy, which included almost eight million surgeries between 1998 and 2010. About two-thirds of the patients were men.
Hospital admissions decreased annually, and overall the risk of dying in the hospital was less than one percent.
In-hospital deaths following urologic surgery stayed stable over the study period but deaths attributable to "failure to rescue" following recognizable or preventable complications, increased 1.5 percent per year on average, Sammon said.
Recognizable or preventable complications included sepsis, pneumonia, blood clots, shock or cardiac arrest. Upper gastrointestinal bleeding during admission for surgery was also included.
Older, sicker and minority patients or those with public insurance were more likely to die as a result of a potentially preventable cause, according to the results published in BJU International.
"There's a pretty wide variety of types of procedures here, but they tilt toward men because they include prostate procedures," said Dr. Hung-Jui Tan, a urology fellow at UCLA who was not involved in the new study.
Overall the mortality rates were quite low, even lower than some other studies have found, he told Reuters Health.
Healthier patients being treated without being inpatients could be one explanation for the rise in inpatient deaths from complications, but it could also have to do with a increasing emphasis on coding and accounting for complications that could lead to mortality over the period of the study, he said.
"Making surgery safer down the road will really involve being aware of complications that have the highest risk of downstream issues, morbidity and death," Tan said.
Patients should not be concerned that their outpatient procedures may be unsafe, he said.
"For urology patients the rate of both in-hospital mortality and (failure to rescue) are lower than for the overall surgical population," Sammon said. "That said, while improvements in mortality and (failure to rescue) mortality are being made in the overall surgical population that is not the case for urology patients."
Patients should be encouraged to seek care at institutions that perform a large number of whatever procedure they require, which may require more travel, he noted.
SOURCE: http://bit.ly/VCWOfJ BJUI, online August 19, 2014.
Tech investor gets five towns to join social-health experiment
By Christina Farr
SAN FRANCISCO (Reuters) - Technology investor Esther Dyson thinks she has found the answer to America's growing health concerns, and has enlisted five smaller cities across the country to try to prove it.
Dyson, an early investor in Square and board member for Yandex, Russia's answer to Google Inc, has drafted five towns to participate in a five-year long test, or what she calls a "healthy living challenge."
By introducing programs and urban planning initiatives, such as wholesome school lunches, corporate wellness programs and more bike paths, Dyson hopes to reduce overall rates of obesity and chronic disease in these towns.
Dyson calls this the "Way to Wellville," where such programs reinforce each other, promote awareness, and hopefully avert expensive healthcare costs over the long term.
Its sponsor is a nonprofit organization called the Health Initiative Coordinating Council, or HICCup, which Dyson founded. HICCup will help local officials find funding from social investors, local businesses and philanthropic organizations.
Each of the towns expects to spend between $20 million and $80 million over the next five years. HICCup, run by former insurance executive Rick Brush, has set aside some $5 million for administrative costs.
The five towns are: Muskegon, Michigan; Lake County, California; Spartanburg, South Carolina; Clatsop County, Oregon; and Niagara falls, New York. These communities all have populations of less than 100,000 people, and their local officials are fully on board with the initiative, Dyson said.
Dyson hopes to establish a model for other communities and provide direct feedback to policymakers in government. Her experiment is timely, given the Obama Administration's support for "population health" initiatives as a means to cut spiraling costs. Population health advocates push for increased funding for preventative measures for groups of patients to reduce rates of chronic illness.
For instance, if a town invests a small sum into programs to inform citizens about the health risks associated with fast food, as well as counseling for pre-diabetes, it could avoid thousands of dollars in medical care and reduced work productivity.
"The programs by and large won't be remarkable," Dyson said. "What's remarkable is doing them together, reinforcing one another, and critical density, in small self-contained communities where they will have maximum impact."
Cancer screenings common among older, sick Americans
By Andrew M. Seaman
NEW YORK (Reuters Health) - Despite potential risks and limited benefits, many Americans are still screened for cancers toward the end of their lives, according to a new study.
Up to half of older people in the U.S. received cancer screenings even though there was a high likelihood that they would die within nine years without cancer, researchers report in JAMA Internal Medicine.
"There is general agreement that routine cancer screening has little likelihood to result in a net benefit for individuals with limited life expectancy," write Dr. Trevor Royce and his fellow researchers from the University of North Carolina, Chapel Hill.
Several professional societies have updated their cancer screening guidelines to suggest that people who aren't expected to live another 10 years should not be screened for certain cancers.
For example, the American Society of Clinical Oncology, the American Cancer Society and the American Urological Association recommend stopping prostate-specific antigen (PSA) screening among men not expected to live another decade.
PSA screening involves a blood test that looks for a protein produced by the prostate gland. High levels of the protein may suggest the presence of prostate cancer.
"Each screening test carries different risks and benefits," said Keith Bellizzi of the University of Connecticut's Center for Public Health and Health Policy in Storrs. "Individuals should be counseled about these risks in order to make an informed decision (sometimes involving caregivers or family members)."
Bellizzi was not involved with the new study but has done similar research (see Reuters Health story of December 12, 2011 here: http://reut.rs/1taT7L9).
"Having said that, the challenge for clinicians is to balance the values and wishes of their patients with the available evidence regarding the benefit or lack of benefit for a specific screening test," he wrote in an email to Reuters Health.
For the new study, the researchers analyzed data from a U.S. survey collected between 2000 and 2010 that included responses from 27,404 people 65 years old and older.
They used the participants' responses to estimate their risk of death within the next nine years. Then, they looked to see who had recently been screened for prostate, colon, breast and cervical cancers.
In one way or another, medical organizations support stopping screening for those four cancers among people with limited life expectancy.
Despite those guidelines, the researchers found 55 percent of men who had a 75 percent risk of death over the next nine years had recently received a PSA screening.
About a third of women with the same life expectancy received breast and cervical cancer screenings. Screening for cervical cancer was also common among women who had already had a hysterectomy.
The researchers also found that 41 percent of people who were not likely to live another decade were recently screened for colon cancer.
In an editorial accompanying the new study, Dr. Cary Gross of Yale University in New Haven, Connecticut, writes that some research found that older Americans receive colonoscopies within seven years of their previous screening. Current recommendations suggest 10 years between colonoscopies with normal results.
Another study published in the same journal says that based on a computer model, screening older adults with colonoscopies more than once every 10 years produced small benefits.
Researchers led by Frank van Hees of Erasmus University Medical Center in the Netherlands found that compared with screening older Americans with colonoscopies every 10 years, screening them every five years saved less than one additional life per 1,000 people.
Screening older Americans with colonoscopies every five years also resulted in less than one quality year of life gained per 1,000 people at a cost of about $711,000.
"This new age of skepticism is providing us with critical tools to better target screening efforts," Gross wrote. "In situations in which we are uncertain about whether benefits outweigh the risks, we need to bolster our efforts to generate evidence that can inform cancer screening decisions."
While helpful, he added, additional research is inefficient and doctors and regulators need to take steps to address the use of cancer screenings among people with limited life expectancies.
"These findings support other studies that suggest certain segments of the older population may be inappropriately screened for cancers," said Bellizzi. "However, the health care response should clearly not be a one size fits all solution."
He said older adults and their health statues differ from one another.
"Age, in and of itself, should not be a proxy for health status or be solely used as a decision tool regarding screening for a particular cancer," he added.
SOURCE: http://bit.ly/1taSAbY, http://bit.ly/1taSAce and http://bit.ly/1taSxNy JAMA Internal Medicine, online August 18, 2014.
NSAIDs tied to reduced breast cancer recurrence among obese
By Andrew M. Seaman
NEW YORK (Reuters Health) - In overweight women, aspirin or other drugs that reduce inflammation might make certain breast cancers more treatable, researchers suggest.
Hormone-driven breast cancer was less likely to return in overweight women who regularly used anti-inflammatory medicines, they found.
But their findings don't prove the drugs prevent cancer and it's too soon to tell women to start taking them to protect against cancer recurrence, the researchers warn.
Still, senior researcher Linda deGraffenried of The University of Texas in Austin told Reuters Health said, "I was probably as surprised as anyone that we found such a dramatic effect that we did."
She and her colleagues write in the journal Cancer Research that in past studies, breast cancer outcomes tended to be worse in obese women than in thinner women.
That's thought to be particularly true for postmenopausal women with a type of breast cancer that is fueled by the hormone estrogen.
Women produce significantly less estrogen after menopause, but an enzyme in fat still makes estrogen from other compounds. Postmenopausal women with estrogen-driven breast cancer can take medicine to stop that process, but those drugs are less effective among the obese.
To see if there was a link between use of so-called non-steroidal anti-inflammatory drugs, or NSAIDs, and the risk of breast cancer returning, the researchers looked at data from 440 women treated in Texas for estrogen-driven breast cancer between 1987 and 2011. Most of the women were overweight or obese and had gone through menopause.
NSAIDs - including aspirin, ibuprofen and naproxen - reduce inflammation throughout the body.
About 6 percent of women who reported regular NSAID use had their cancers return, compared to about 12 percent of those who didn't report regular NSAID use.
The cancers that did return among those who used NSAIDs also tended to reappear later than the cancers of those who didn't take NSAIDs, the researchers found.
Using lab experiments and blood samples, the researchers then sought to find an explanation for the link between regular NSAID use and the risk of returning breast cancer among overweight women.
Compared to normal weight women, deGraffenried said the lab results suggest that the bodies of overweight women are more hospitable environments to estrogen-driven breast cancers and make it more difficult for treatments to work.
By reducing inflammation through the use of NSAIDs, the environment within the bodies of obese women in which the cancer lives becomes more like the environment of normal weight women.
"We are really truly starting to appreciate that it takes a village to support a cancer growth," deGraffenried said.
It's too soon to tell obese women to start taking aspirin or other NSAIDs to reduce the risk of their breast cancer from coming back, she and another researcher said.
"What this study does is provide more evidence for the plausibility of this," Dr. Clifford Hudis, who was not involved with the new study, told Reuters Health.
Hudis, chief of the Breast Cancer Medicine Service at Memorial Sloan Kettering Cancer Center in New York City, said the new study had some limitations.
"The women in this study were not randomly assigned to take or not take the drug in question," he said. "The doctor recommended it to them or they chose to take it for some other reason. It wasn't assigned to them. It does not show and it's far short of showing causation."
More reliable studies are being planned, deGraffenried said.
"These studies give promise but they're still preliminary," she said.
SOURCE: http://bit.ly/1BjUomK Cancer Research, online August 14, 2014.