Free app highlights most effective types of birth control, reveals potential side effects, risks.

Screen shot: Plan A Birth Control app

A new, free iPad application developed at UCLA helps women navigate through the sometimes confusing process of selecting a birth control method using medically accurate information. The easy-to-use app highlights the most effective types of birth control and reveals potential side effects and risks associated with each option.

The app, called Plan A Birth Control or Plan ABC, is designed to help a woman prepare for her visit with a contraception counselor or an OB-GYN. It was developed by Dr. Aparna Sridhar, a clinical fellow in family planning in the UCLA Department of Obstetrics and Gynecology.

“Women using the app will be better informed and already have a baseline knowledge about what they’re looking for when they see their doctors,” said Sridhar, who is completing her master’s degree at the UCLA Fielding School of Public Health. “That way, doctors may need less time to explain the different birth control methods, and can spend more time focused on a more narrow discussion tailored to the individual patient and her particular needs.”

Available in iTunes, the app lists the top 10 forms of reversible birth control from most to least effective, ranging from the IUD to hormonal treatments to the female condom. Sridhar drew the content for Plan ABC from respected family-planning websites and vetted it for accuracy. One of her goals in creating the app was to ensure that women could easily access the most current, medically correct information, because much of the information on the Internet is either unreliable or dated, she said.

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Experts provide free answers about medications and more during pregnancy, breastfeeding.

As Mother’s Day approaches, the UC San Diego School of Medicine announces MotherToBaby CA, the new name of its free, statewide counseling service that connects experts in the field of birth defects research with moms-to-be and the general public. MotherToBaby CA was formerly known as the California Teratogen Information Service (CTIS) Pregnancy Health Information Line and is housed at the Center for the Promotion of Maternal Health and Infant Development, a division of UC San Diego and Rady Children’s Hospital.

MotherToBaby CA is an affiliate of the international non-profit Organization of Teratology Information Specialists (OTIS), a prestigious professional society that supports and contributes to worldwide initiatives for teratology education and research. MotherToBaby affiliates and OTIS, which are suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC), are dedicated to providing evidence-based information to mothers, health care professionals and the general public about medications and other exposures during pregnancy and while breastfeeding.

“In addition to my primary health care provider, MotherToBaby experts offered me an added layer of support by giving me an individualized risk assessment,” said Pamela Salgado, a San Diego resident who called the service when she was thinking about getting pregnant. She had questions about the safety of a long-term medication she was taking and its potential risks during pregnancy. “Afterwards, I felt informed and empowered to make smart decisions about my health. Today, I have a healthy 3-year-old boy.”

All North Americans can be connected with MotherToBaby experts toll free through its phone counseling service (866) 626-6847 or online at MotherToBabyCA.org, where a private, online chat counseling service is also offered.

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UC San Diego findings emphasize need to educate women about taking multivitamins.

Researchers from the UC San Diego Department of Pediatrics and Rady Children’s Hospital-San Diego, a research affiliate of UC San Diego School of Medicine, have found a link between multivitamin use and alcohol consumption before pregnancy, uncovering a need for education about the importance of vitamin supplementation, particularly among women who drink alcohol during their childbearing years. The study was published online this month in Alcoholism: Clinical and Experimental Research.

Researchers examined data collected from the Centers For Disease Control and Prevention’s multiple-state Pregnancy Risk Assessment Monitoring System (PRAMS) of more than 100,000 women between 2004 and 2008. The women answered a series of questions about alcohol use before their pregnancies as well as multivitamin supplement use.  The study found women who reported consuming alcohol regularly or binge drinking were significantly less likely to take a multivitamin supplement compared with those who did not report alcohol consumption.

“It’s likely a woman may consume alcohol before she even realizes she’s pregnant, therefore, these findings are significant,” explained Lauren Bartell Weiss, Ph.D., a postdoctoral research fellow at UC San Diego’s Center for the Promotion of Maternal Health and Infant Development and co-author of the study. “If a woman is drinking alcohol regularly and unintentionally becomes pregnant, not only does her unborn child have a greater risk of being affected by the alcohol, but other studies suggest that alcohol can also alter the metabolism of nutrients and interfere with the nutritional supply to the developing baby.”

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Painful, chronic condition often occurs after breast cancer surgery.

Bradley Aouizerat, UC San Francisco

A new UC San Francisco study has found a clear association between certain genes and the development of lymphedema, a painful and chronic condition that often occurs after breast cancer surgery and some other cancer treatments.

The researchers also learned that the risks of developing lymphedema increased significantly for women who had more advanced breast cancer at the time of diagnosis, more lymph nodes removed or a significantly higher body mass index.

The study is the first to evaluate genetic predictors of lymphedema in a large group of women using a type of technology, bioimpedance spectroscopy, to measure increases in fluid in the arm. Bioimpedance spectroscopy is a noninvasive procedure that allows one to measure body composition including an increase in fluid in an arm or a leg.

The study, which involved some 400 women who were tracked over four to five years, will be published online today (April 16) in PLOS ONE.

“The genetic markers found in our study make perfect sense,” said senior author Bradley Aouizerat, Ph.D., a professor at the UCSF School of Nursing in the department of physiological nursing. “These genes are ‘turned on’ later in the development of our lymph system and blood vessels. They appear to play a role in the ability of our lymphatic system to function on an ongoing basis. It is possible in some individuals who have changes in these genes, that lymphedema could develop after an injury like breast cancer surgery because these genes do not function properly.”

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Outcome calls into question the costs of CAD-enhanced mammography.

Joshua Fenton, UC Davis

A costly and widely used mammography add-on increases detection of noninvasive and early-stage invasive breast cancer but also makes more mistakes than mammography alone, researchers from UC Davis and the University of Washington have found.

Published in the April 16 issue of the Annals of Internal Medicine, the study of women enrolled in Medicare is the largest comparison of clinical outcomes of routine screening mammography with and without computer-assisted detection (CAD) — software developed to enhance the detection of breast cancer during screening mammography.

CAD was most strongly associated in the study with higher incidence of ductal carcinoma in situ (DCIS), a non-invasive breast lesion typically referred to as “stage 0” because it does not affect surrounding tissue or mortality.

“DCIS progresses slowly, if at all,” said lead author Joshua Fenton, an associate professor of family and community medicine at UC Davis and a national leader in research to improve the quality of health care services. “Some of these early noninvasive lesions may never have come to clinical attention in women’s lifetimes if CAD were not applied to their mammograms.”

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UCLA nursing hosting event April 11-13.

New findings on the role gender plays in the diagnosis, treatment and prevention of heart disease will be among the research topics highlighted by faculty members and students from the UCLA School of Nursing at the annual Western Institute of Nursing Conference, which runs from April 11 to 13 in Anaheim.

At a special state-of-the-science panel on Saturday, April 13, UCLA professor Lynn V. Doering will present a review of gender differences in identification, treatment and outcomes for cardiovascular disease, with a focus on coronary atherosclerosis, heart failure and stroke. During the same panel, UCLA professor JoAnn Eastwood will introduce her novel study in which she is partnering with a community organization and using mobile health technologies to reduce cardiac risk factors among young minority women.

“Cardiovascular disease is the No. 1 killer of women and accounts for more female deaths than all cancers and lung disease combined,” Doering said. “Heart disease — particularly its symptoms — presents differently in women, and it is not so obvious in current testing, so it is harder to diagnose. The cutting-edge work that is being presented will provide critical information on diagnosis, treatment and prevention of cardiovascular disease in women.”

Also during the three-day conference, UCLA School of Nursing faculty and doctoral students will present symposia on health care and nursing education for vulnerable populations and on the behavioral symptoms of dementia.

During the symposium “Cultivating Nurse Leaders: A Framework for Nursing Education in Vulnerable Populations” on Friday, April 12, three UCLA nursing researchers will discuss their work on finding ways to eliminate the cultural, financial and language barriers that impact health care delivery. Health disparities continue to exist among vulnerable populations, the researchers stress, and addressing inequities requires mentoring and guiding new nurse–scientists to conduct research in this important area.

On Saturday, April 13, “Promoting the Health of Vulnerable Populations” will take a look at the challenges of meeting the health care needs of four vulnerable populations: homeless men on parole, homeless men and women who suffer from frailty, methamphetamine users who are mothers, and American Indians suffering effects of abuse.

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School has received nearly $21M from First 5 LA for dental programs.

James Crall, UCLA

The UCLA School of Dentistry has been awarded funding of more than $11 million from the Los Angeles–based child advocacy and grant-making organization First 5 LA to expand access to dental care in Los Angeles.

The funds will establish the UCLA–First 5 LA Children’s Dental Care Program (CDCP), which will support the delivery of care to children, from birth to age 5, and pregnant women over the next five years. The program will be especially beneficial to those in underserved communities, who are at high risk for dental disease, school officials said.

This new award comes on the heels of the $9.23 million that First 5 LA awarded to the dental school last year, bringing the total amount the school has received from the organization to nearly $21 million over the past 12 months.

“Our goal, over the next five years, is to develop an integrated health care delivery system that will provide quality, ongoing dental care to underserved young children and pregnant women in Los Angeles communities,” said Dr. James J. Crall, project director of the CDCP. “We hope the Children’s Dental Care Program will serve as a prototype for transforming the oral health care system for young children throughout Los Angeles County and beyond.”

As part of the new program, UCLA faculty members hope to gain a better understanding of the barriers that limit the use of dental care services by underserved groups in order to initiate improvements in care.

“While focusing on dental care for young children, the program is also targeting pregnant women in an effort to provide them with the information and education they need to be able to provide a more positive and healthier approach to oral health for their developing children,” Crall said.

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Some younger women see both benefit and harm from annual exams, study finds.

Screening for breast cancer every two years appears just as beneficial as yearly mammograms for women ages 50 to 74, with significantly fewer “false positives” – even for women whose breasts are dense or who use hormone therapy for menopause.

That is the finding of a new national study involving more than 900,000 women that was published today (March 18) in JAMA Internal Medicine.

The same team of researchers from UC San Francisco and Seattle-based Group Health Research Institute recently reported similar results for older women ages 66 to 89.

By contrast, women in their 40s with extremely dense breasts who undergo biennial mammography are more likely to have advanced-stage and large tumors than women who undergo annual mammography – but annual mammograms also resulted in more false positives, according to the new study from the Breast Cancer Surveillance Consortium (BCSC), the largest available screening mammography dataset in the United States. Having dense breasts means it is difficult for X-rays to pass through the breast tissue.

“Increasing age and high breast density are among the strongest risk factors for the disease,” said senior author Karla Kerlikowske, M.D., a professor of medicine at UCSF and a physician at the UCSF-affiliated San Francisco VA Medical Center.

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Surgeon Laura Esserman to receive tribute from nationwide organization.

Laura Esserman, UC San Francisco

The American Cancer Society will pay tribute to Laura Esserman, M.D., M.B.A., an internationally known leader in the field of breast cancer care and research.

A surgeon and 20-year member of the faculty at UC San Francisco, Esserman is leading an effort to change the delivery of breast cancer services and the information systems used to support both research and patient care.

She will be honored Tuesday (March 19) at the Four Seasons Hotel in San Francisco. Established in 1913, the American Cancer Society is a nationwide voluntary health organization dedicated to eliminating cancer.

As a professor of surgery and radiology, Esserman co-leads the Breast Oncology Program and serves as associate director of the UCSF Helen Diller Family Comprehensive Cancer Center.

She is a member of President Obama’s Council of Advisors on Science and Technology (PCAST) Working Group on Advancing Innovation in Drug Development and Evaluation, which is studying how the federal government can best support science-based innovation in the process of drug development and regulatory evaluation.

Esserman has worked at UCSF to develop interdisciplinary teams of clinicians and researchers to bring the best care to patients and find the best platform to integrate translational research and improve the delivery of breast cancer care.

Director of the Carol Franc Buck Breast Care Center at UCSF, she is founder and faculty leader of the program in Translational Informatics spanning the disciplines of bioinformatics, medical and clinical informatics, systems integration, and clinical care delivery.

Esserman is the principle investigator of the I-SPY TRIAL program, a multisite neoadjuvant clinical trial that has evolved into a model for translational research and innovation in clinical trial design. I-SPY combines personalized medicine with a novel investigational design to identify women at high risk of early breast cancer recurrence. It is under way at 19 major cancer centers around the country.

Esserman has recently launched a University of California-wide breast cancer initiative called the Athena Breast Health Network, a groundbreaking project designed to follow 150,000 women from screening through treatment and outcomes, incorporating the latest in molecular testing and Web-based tools into the course of care.

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U.S. News gives high marks to UC medical schools.

University of California Health ranked among the nation’s best graduate schools in a survey released today (March 12) by U.S. News & World Report.

Five UC medical schools placed in the top 50 nationally for research rankings and four placed in the top 40 nationally for primary care rankings.

In research, UC San Francisco was the top-ranked public school and tied for fourth among all U.S. schools, with UCLA 13th overall, UC San Diego 15th, and UC Davis and UC Irvine tied for 42nd. In primary care, UCSF ranked fourth, UCLA ranked 11th, UC Davis tied for 19th and UC San Diego tied for 39th, with UC Irvine tied for 66th. UCSF has the only medical school ranked in the top five of both categories.

UC medical schools also received high marks in a number of specialty programs. UCSF ranked first for its medical program in AIDS, second in both internal medicine and women’s health, tied for second in drug/alcohol abuse education, fourth in family medicine, sixth in geriatrics, and seventh in pediatrics. UCLA ranked third in geriatrics, seventh in drug/alcohol abuse education, tied for ninth in AIDS and 10th in women’s health. UC San Diego ranked ninth in drug/alcohol abuse education and 11th in AIDS.

U.S. News’ 2014 America’s Best Graduate Schools rankings were released online today (March 12) and can be viewed at www.usnews.com/grad.

The new rankings include previous assessments of a number of other health fields, which U.S. News also surveys but not each year. UCLA ranked first in clinical psychology, UCSF ranked first in pharmacy, UC Davis ranked second in veterinary medicine, UCSF ranked fourth for both its master’s of nursing program (tied) and its nursing-midwifery program, while in public health UC Berkeley tied for eighth and UCLA was 10th. The surveys do not rank dental or optometry schools.

UC Health runs five academic health centers and the nation’s largest health sciences education system with more than 14,000 students and 18 health professional schools and programs in medicine, dentistry, nursing, optometry, pharmacy, public health and veterinary medicine. UC’s sixth medical school, UC Riverside, will enroll its first class this fall.

Related links:

• UC Davis
• UC Irvine
• UCLA
• UC San Diego
• UC San Francisco

UCLA study results suggest low support a significant risk factor for postpartum depression.

Jennifer Hahn-Holbrook, UCLA

Women who receive strong social support from their families during pregnancy appear to be protected from sharp increases in a particular stress hormone, making them less likely to experience depression after giving birth, a new study by UCLA life scientists indicates.

“Now we have some clue as to how support might ‘get under the skin’ in pregnancy, dampening down a mother’s stress hormone and thereby helping to reduce her risk for postpartum depression,” said Jennifer Hahn-Holbrook, a UCLA National Institute of Mental Health postdoctoral scholar in psychology, a fellow at UCLA’s Institute of Society and Genetics, and the lead author of the research.

The scientists recruited 210 pregnant women of different ethnicities and socioeconomic backgrounds, surveying them three times during pregnancy — at 19, 29 and 37 weeks — and then eight weeks after giving birth. The women were asked in interviews about how much support they received from their families and the child’s father and about their symptoms of depression. In addition, blood samples from all participants were analyzed to assess their levels of placental corticotropin-releasing hormone (pCRH), a stress hormone released from the placenta.

After taking into account factors such as age, education and income, Hahn-Holbrook and her colleagues discovered that pregnant women who reported the greatest support from their families had lower levels of depressive symptoms. They also had the least dramatic increases in pCRH and the lowest absolute levels of pCRH in the third trimester of pregnancy.

Additional analyses revealed that pCRH levels in the third trimester fully explained the relationship between family support in pregnancy and postpartum depression symptoms.

These results are consistent with the idea that social support limits abnormal pCRH increases and that lower pCRH levels, in turn, reduce the risk of postpartum depression. The research is published today (March 4) in the online edition of the journal Clinical Psychological Science and will be published in an upcoming print edition.

“Our results, and those of other scientists, suggest that low or absent support is a significant risk factor for postpartum depression and that strong support is a protective factor,” Hahn-Holbrook said.

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Forum highlights student-designed red dresses, heart-healthy recipes and more.

Amparo Villablanca (left) and Crystal Ching

Crystal Ching has no family history of heart disease. She is under 50. Her cholesterol is low. She maintains a healthy weight. Yet she has heart disease.

“Suddenly one day I was overwhelmed by fatigue, general upper body pain and nausea,” said the Sacramento business owner. “When my husband said I could be having a heart attack, I told him it was impossible because I was too young.”

A stress test and angiogram, however, showed three blockages in her blood vessels, one of which was 90 percent occluded and could have been life threatening.

“Crystal describes herself as the new poster child for heart disease,” said Amparo Villablanca, Ching’s UC Davis cardiologist. “She is proof that it is not just a disease of older people. And even though heart disease kills more women than men, most women do not think they are at risk and are not aware it is their leading killer.”

Ching shared her heart-disease recovery story at the Feb. 22 Women’s Heart Care Education and Awareness Forum, which is held in Sacramento each year during National Heart Month and hosted by the UC Davis Women’s Cardiovascular Medicine Program. The event brought more than 300 community leaders together to hear the latest information on heart-disease prevention. Attendees were encouraged to wear red — especially red dresses — the national symbol of solidarity in raising awareness of heart disease in women.

Villablanca, director of the Women’s Cardiovascular Medicine Program, encouraged all women at the event to “know their numbers,” including their triglyceride levels and blood pressure, so they can actively track their heart disease risk factors. She also asked them to learn the warning signs of a heart attack, some of which are unique for women, and to call 9-1-1 if they experience any of the symptoms.

To broaden the heart-health message across generations, the forum showcased red dresses designed by UC Davis fashion design students and created through a unique partnership Villablanca established in 2010 with the UC Davis Department of Design.

“This is the fourth year that some of our advanced fashion design students have unveiled red dresses at the forum, and I am always fascinated with how unique each and every dress is,” said Adele Zhang, a lecturer in the design department and mentor for the student designers. “The process highlights the deeply personal nature of heart disease while sharing important prevention messages with the broader public.”

Ching is definitely a believer in the power of prevention. Her primary diseased vessel now has a stent, and she has taken steps to ensure that she doesn’t have another cardiac event.

“I am a different person today,” she said. “I don’t eat meat, I’ve cut way back on the fat in my diet and I go to a gym regularly. I work hard every day on controlling my heart disease, even though it doesn’t look like I have to.”

More information about heart health for women is available at womenshearthealth.ucdavis.edu.

The forum was funded in part by the Nora Eccles Treadwell Foundation and co-sponsored by the UC Davis Center for Reducing Health Disparities. Television station Univision 19 was a media partner for the event.

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