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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
Kidney patients know little about transplant benefits
By Ronnie Cohen
NEW YORK (Reuters Health) - In a new study, the vast majority of kidney failure patients told researchers they saw no need for a kidney transplant because they were doing fine on dialysis - but the researchers say these patients might not realize how much a transplant could help them.
"Nobody is doing fine on dialysis to the point where a transplant wouldn't be better for them," senior author Dr. Dorry Segev told Reuters Health. "Transplantation is the better form of renal replacement."
A kidney transplant doubles a recipient's life expectancy, said Segev, a transplant surgeon at the Johns Hopkins Hospital in Baltimore, Maryland.
His group's study, published in the Clinical Journal of the American Society of Nephrology, showed a gap in dialysis patients' knowledge about the benefits of transplants over dialysis, Segev said.
Researchers surveyed 348 patients being treated at 26 Baltimore-area freestanding dialysis centers, asking whether a dozen potential concerns constituted reasons they would not pursue a transplant. The average age was 56 and half the patients had been on dialysis for at least two months.
Overall, more than 68 percent of the patients told researchers "I'm doing fine on dialysis."
The older the patient, the more likely they were to report feeling fine on dialysis, the study found.
Less educated patients were more likely to report being content with dialysis than those with higher degrees, the study found.
Almost a quarter of patients had not seen a nephrologist (a doctor who specializes in kidney disease) before starting dialysis - and these people were almost twice as likely to report that no one had discussed a possible transplant with them.
Nearly 30 percent of participants reported feeling uncomfortable asking a friend or relative to donate a kidney, the study found. The authors say such reluctance to ask friends and relatives to donate kidneys is consistent with prior studies.
Also consistent with prior studies, the researchers found that women tended to be more fearful about transplants than men, with 26 percent of women saying they feared a transplant compared to less than eight percent of the men.
Women do just as well after a transplant as men, if not better, Segev said. "That's another area where we need to work on education and assurance," he said.
In sum, he said, the study points to a lack of education for renal-failure patients about the benefits of kidney transplants.
"This is another set of evidence that we have a problem in how well we are educating people at the time of their kidney disease," he said. "We really need to find a better way to educate people about transplantation."
Jesse Schold agreed. He has done similar research at the Cleveland Clinic but was not involved with the current study.
"The preponderance of research shows that transplantation doubles life expectancy, improves quality of life and reduces healthcare costs," he told Reuters Health.
"It's certainly interesting and to most people would be relatively startling" to realize how many patients aren't pursuing transplantation because they say they're doing fine, he said.
"Given the overwhelming evidence that transplantation is a better treatment modality, it certainly suggests that more education may be appropriate."
Schold stressed the need for patients suffering from renal failure to see nephrologists and learn about transplants soon after they are diagnosed with renal problems.
Prior research found that kidney-disease patients who are African-American or lack private health insurance are less likely to be matched with donor organs before they need dialysis (see Reuters Health story of January 31, 2013 here: http://reut.rs/1tKdUU2).
Almost 66 percent of the current study participants were African-American. Some 24 percent of them reported feeling uncomfortable asking someone to donate a kidney, compared to 41 percent of other participants.
Americans who receive kidneys from unrelated live donors tend to be white, highly educated and live in wealthier neighborhoods, according to an earlier study (see Reuters Health story of April 9, 2012 here: http://reut.rs/ZoGvFw).
A kidney is one of the few organs people can give away and go on to live a healthy life.
Since the 1990s, advances in immune-suppression have made it safer to receive an organ from someone who's not a relative. Less-invasive surgical techniques also make it easier to donate.
SOURCE: http://bit.ly/1uzgihR Clinical Journal of the American Society of Nephrology, online September 11, 2014.
Brain study hints at how fibromyalgia works
By Kathryn Doyle
NEW YORK (Reuters Health) - Brain scans show that people with the pain disorder fibromyalgia react differently to what others would consider non-painful sights and sounds, new research suggests.
The small new study provides clues to what might be going wrong in the nervous system of people with fibromyalgia, along with possible new approaches to alleviating their pain.
"If we understand the mechanism, we may come up with new and potentially better forms of treatment," said lead author Marina López-Solà of the department of Psychology and Neuroscience at the University of Colorado, Boulder.
Fibromyalgia, which patients experience as widespread muscle pain and fatigue, affects as many as five million Americans, most commonly middle-aged women, according to the U.S. Department of Health and Human Services.
Its cause is unknown and there is no cure, but medications can treat the symptoms.
The new results suggest not only that fibromyalgia is related to greater processing of pain-related signals, but also potentially to a misprocessing of other types of non-painful sensory signals that may be important to address during treatment, Lopez-Sola told Reuters Health by email.
She and her team used "functional magnetic resonance imaging," which measures blood flow changes in the brain, to assess brain responses among 35 women with fibromyalgia and 25 similar women without the disorder.
The fibromyalgia patients were more sensitive to non-painful stimulation compared to people without the disorder, they report in Arthritis and Rheumatism.
Researchers showed the subjects some colors, played some tones and asked subjects to perform very simple motor tasks at the same time, like touching the tip of the right thumb with another finger.
Areas of the brain's cortex primarily responsible for processing visual, auditory and motor signals were significantly activated in the healthy comparison group, but not in the fibromyalgia group.
However, other brain regions that are not relevant for primary processing were activated in fibromyalgia sufferers but not in healthy controls.
What seems to be happening is that the brains of fibromyalgia patients are under-processing certain forms of sensory information at the first stages of processing, but are also amplifying the signal at a later level of sensory integration of multiple sensory inputs, Lopez-Sola said.
"When you are in pain, it is probable that you are more concentrated on your own pain than on the tasks you have to pay attention to," said Dr. Pedro Montoya of the Research Institute on Health Sciences at the Universitat Illes Balears in Palma de Mallorca, Spain, who was not part of the new study.
"For me, these findings provide further support for the idea that psychological strategies aimed at changing the focus of attention from the body to external cues could be useful for these patients," Montoya said.
There were only a small number of people involved in the study, and the researchers did not account for other mental health conditions the participants may have had, both factors that limit the results, said Dr. Winfried Hauser, associate professor of Psychosomatic Medicine at Technische Universitat Munchen in Germany.
People with fibromyalgia often also have conditions like depression, so some people believe the disorder has a mental basis, said Michael E. Geisser, professor in the department of physical medicine and rehabilitation at the University of Michigan in Ann Arbor.
But evidence for a neuro-anatomical basis for fibromyalgia is growing, said Geisser, who was not part of the new study.
"There is increasing evidence that fibromyalgia is not just a pain condition," he told Reuters Health by email. "More recent research done on persons with fibromyalgia, such as the research by Lopez-Sola and colleagues, suggests that persons with fibromyalgia suffer from a central processing deficit of multiple types of sensory stimuli, not just pain."
"It's as if the volume control for sensation in persons with fibromyalgia is turned up, or louder, for many types of sensation compared to persons without the disorder," he said.
That might help explain why many people with fibromyalgia also often suffer from fatigue, cognitive problems or mood disturbance, Geisser said.
Currently, people with the disorder can take anticonvulsant medications, such as pregabalin (Lyrica), and antidepressants such as duloxetine (Cymbalta) and milnacipran (Savella), which have been FDA approved for treating fibromyalgia.
Further research to improve understanding of where there are problems in the brain for people with the disorder could lead to the development of new treatments, Geisser said.
For example, it would be interesting to see if a treatment targeted at dampening response in an area of the brain that "overreacted" in this study helped to treat fibromyalgia symptoms, he said.
SOURCE: http://bit.ly/1mbOikg Arthritis and Rheumatism, online September 15, 2014.
Angelina Jolie surgery sparks surge in female cancer tests-study
By Laura Onita
LONDON (Thomson Reuters Foundation) - Hollywood star Angelina Jolie's decision to make public her double mastectomy more than doubled the number of women in Britain seeking to have genetic breast cancer tests, according to a study released on Friday.
Jolie, 39, who has become a high-profile human rights campaign, announced her surgery in May last year, saying she acted after testing positive for a mutation of the BRCA1 gene that significantly increases the risk of breast cancer.
She said she was going public with news of her surgery as she hoped her story would inspire other women to fight the life-threatening disease.
Researchers studied 21 clinics and regional genetic centers and found there were 4,847 referrals for testing in June and July last year compared to 1,981 in the same period of 2012.
The study of the so-called "Angelina effect", published online in the journal Breast Cancer Research, credited Jolie's glamorous appearance and relationship with Hollywood actor Brad Pitt for helping to lessen women's fears about surgery.
"Angelina Jolie ... is likely to have had a bigger impact than other celebrity announcements, possibly due to her image as glamorous and strong woman," researcher Gareth Evans of the charity Genesis Breast Cancer Prevention said in a statement.
"This may have lessened patients' fears about a loss of sexual identity post-preventative surgery and encouraged those who had not previously engaged with health services to consider genetic testing."
"These high-profile cases often mean that more women are inclined to contact centers such as Genesis - and other family history clinics - so that they can be tested for the mutation early and take the necessary steps to prevent themselves from developing the disease," he continued.
"Of course, in some cases this may mean a risk-reducing mastectomy, however cancer preventing drugs, such as tamoxifen, and certain lifestyle changes like a healthy diet and more exercise, are also options which many women may consider."
Breast cancer is the most common cancer in women worldwide. The World Health Organization estimated that more than 521,000 women died of breast cancer in 2012.
Oscar-winning Jolie has in recent years drawn nearly as much attention for her globe-trotting work on behalf of refugees and victims of sexual violence in conflicts as for her acting.
Jolie was named a Goodwill Ambassador for the UNHCR in 2001 and promoted to be Special Envoy to High Commissioner Antonio Guterres in 2012. Since 2012 she has also led a campaign against sexual violence in conflict zones.
SOURCE: http://bit.ly/1u5z5nc Breast Cancer Research, September 18, 2014.
U.S. nutrition program for mothers, infants sees falling demand
By Annika McGinnis
WASHINGTON (Reuters) - A government nutrition program for pregnant mothers and small children has not kept pace with technology and U.S. poverty experts say its paper voucher system is driving low-income women away from the program when they need it most.
The Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, has seen a sharp drop in participation since 2010, unlike food stamps and other anti-poverty programs that ballooned during the 2007-9 recession and the economic recovery that followed, government figures show.
"WIC providers are tearing their hair, beating their chests, 'what are they doing wrong?'" said Laurie True, California WIC Association director.
Poverty experts say the shrinking demand does not reflect less need. They are pushing for faster changes to an outdated, cumbersome distribution process they say stigmatizes recipients.
Participants complain of customers "shaming" them in grocery lines, said Sarah Monje, California's Native American Health Center WIC director.
"I can feel the aura: 'Oh my god, this girl is taking forever,'" said WIC recipient Marquel Davis of Austin, Texas.
With a generation of Americans "used to getting everything on their smartphones," True said, WIC is still "stuck in the hands-on experience."
"That doesn't make the program as attractive to people who may be on the borderlines, the working poor and very busy - most of our participants work at least one job," she said.
Congress mandated in 2010 that WIC switch to electronic benefit cards by 2020. All but nine U.S. states still rely on paper vouchers that program directors say hold up grocery-store lines and embarrass mothers.
Davis, 26, said it was a hassle trying to redeem her WIC checks before Texas switched to an electronic system several years ago. The program pays only for specified foods sold in certain quantities.
"You've got to separate (your groceries) and make sure it's the right one, right size, and on top of that, you got to sign and they got to initial," Davis said. "It's just hectic, especially if you have a kid shopping with you and you're trying to get home."
WIC gives low-income pregnant, post-partum or breastfeeding women and kids up to age five vouchers worth about $43 each month for formula and healthy foods that adhere to federal nutrition requirements, such as limiting added sugar in yogurt and mandating that bread include whole wheat flour.
The program requires recipients to attend classes on eating well and breastfeeding.
Though WIC grew fairly steadily since its inception in 1972, U.S. Department of Agriculture data shows it shrank 10.6 percent between fiscal year 2010 and May 2014.
Staff members "don't have a sense of declining need in their communities," said analyst Zoe Neuberger of the Center on Budget and Policy Priorities, a poverty-focused think tank.
Participants dropped from 9.2 million to 8.2 million from 2010 to May, decreasing in every state and the District of Columbia, according to USDA. In Georgia, caseload plummeted 46 percent since 2009.
Conversely, food stamp enrollment skyrocketed from 28.2 million in 2008 to 47.6 million in 2013 under expansions in President Barack Obama's 2009 stimulus package, though it fell to 46.2 million in May after benefits expired last November.
But the smaller, more targeted WIC started shrinking years earlier and to a greater extent relative to enrollment, USDA data shows.
The social stigma, always a factor for some people, was accentuated by a distribution system largely unchanged in four decades, directors said.
Many women have switched to food stamps, which use a debit-like card but lack such WIC benefits as affording expensive baby formula, feeding children healthier food and learning workplace breastfeeding rights, directors said.
Being required to attend WIC advising sessions every one to three months can be a problem for low-income workers.
Those include illegal immigrants, who may be deterred over fear of an immigration crackdown, New York-based nonprofit Community Food Advocates co-founder Agnes Molnar said. The WIC program does not require proof of citizenship, though state or tribal residency is required.
Michael Osur, who runs 18 WIC clinics in southern California's Riverside County, saw an almost 40 percent drop in the percentage of people requesting materials in Spanish from 2007 to 2013.
Lingering effects from last October's government shutdown, when clinics shuttered or scraped by on reserve funds, also hurt WIC, National WIC Association CEO Douglas Greenaway said.
If caseload continues to drop, Congress will cut funding and clinics will close, consolidate and limit overtime and weekend services, True said.
In California, Osur was opening mobile neighborhood clinics, insisting many women were neglecting critical help.
"I think the need is there," he said. "We've just got to find a way to reach them."
It's not a small world after all: world population will soar
By Will Dunham
WASHINGTON (Reuters) - Contrary to some earlier projections, the world's population will soar through the end of the 21st century thanks largely to sub-Saharan Africa's higher-than-expected birth rates, United Nations and other population experts said on Thursday.
There is an 80 percent likelihood that the number of people on the planet, currently 7.2 billion, will increase to between 9.6 billion and 12.3 billion by 2100, the researchers said. They also saw an 80 percent probability that Africa's population will rise to between 3.5 billion and 5.1 billion by 2100 from about 1 billion today.
The study, led by U.N. demographer Patrick Gerland and University of Washington statistician and sociologist Adrian Raftery and published online by the journal Science, foresees only a 30 percent chance that earth's population will stop rising this century.
"Previous forecasts did indeed forecast a leveling off of the world population around 2050, and in some cases a decline," Raftery said.
Raftery said the new projections arise from data that clearly establishes that birth rates in sub-Saharan Africa have not been decreasing as quickly as some experts had expected, a trend that was "not as clear when previous forecasts were made."
Raftery said the researchers used data on population, fertility, mortality and migration from every country and then predicted future rates using new statistical models. Some of the figures, such as the median projection of the population hitting 10.9 billion by 2100, mirror a U.N. report published in 2013.
U.N. demographer Gerland said sub-Saharan Africa countries already with big populations and high fertility levels are expected to drive population growth, including Nigeria, Tanzania, Democratic Republic of the Congo, Niger, Uganda, Ethiopia, Kenya, Zambia, Mozambique and Mali.
The world's population reached 1 billion in the early 19th century, doubled to 2 billion in the 1920s and doubled again to 6 billion in the 1990s. It hit 7 billion in 2011.
The findings underscore worries expressed for decades by some experts about a planet growing more crowded and humankind exhausting natural resources, struggling to produce enough food or cope with poverty and infectious diseases.
Raftery said African nations could benefit by intensifying policies to lower fertility rates, with studies showing that greater access to contraceptives and more education for girls and women can be effective.
The researchers projected that Asia's population, now 4.4 billion, will peak at around 5 billion people in 2050, then begin to decline. They forecast that the populations of North America, Europe and Latin America will stay below 1 billion each by 2100.
Among the experts who had predicted the global population rise would peter out was a 2010 report by Austrian demographer Wolfgang Lutz. He forecast it likely would reach 8 billion to 10 billion by 2050 but "population stabilization and the onset of a decline are likely" in the second half of the century.
SOURCE: http://bit.ly/Xq6URw Science, online September 18, 2014.