Obstetrics and Gynecology Ongoing Research Studies
Our ongoing research endeavors in the Obstetrics and Gynecology department play a
pivotal core in not only pinpointing and rectifying healthcare disparities but also
in elevating outcomes in maternal and child health and advancing overall women’s health.
At the core of our mission is the commitment to augmenting access to top-notch healthcare,
engaging in impactful community outreach, fostering cultural competence, championing
advocacy, and forging collaborative partnerships. Through these concerted efforts,
we aspire to leave an enduring positive imprint on the health landscape of the vibrant
city of El Paso, Texas.
Perceptions of Mesh Use for Pelvic Floor Surgery in the Latina Population at the U.S.-Mexico
Border
Description
Limited studies have investigated patients’ knowledge or perceptions of mesh use for
POP or UI surgery. Brown et al found that greater levels of patient education are
needed given the degree of misconceptions regarding mesh surgery.16 Investigators uncovered several misconceptions about mesh use and 57% of patients
would avoid surgery using mesh. Important limitations of existing studies are that
patients are predominantly White, have higher level of education, speak English only,
and surveys are anonymous (which does not allow for correlation between severity of
symptoms and perceptions of mesh or willingness to have surgery with mesh). In such
an area, it is critical that providers understand their patients’ unique attitudes
and beliefs to help guide patient education and decision-making, ultimately providing
more culturally appropriate care to Latina patients.
Her2/neu expression in cervical dysplasia and cancer
Description
Early stage cervical cancer remains primarily treated with surgical intervention,
however late-stage disease has few viable options for treatment. HER2/neu is an oncogene
which has been found to be mutated in several malignancies and presents a viable target
for treatment. Literature regarding HER2/neu expression in cervical dysplasia and
cancer is promising, however limited studies and sample sizes limit clinical applicability.
This study aims to further expand HER2/neu expression evaluation among cervical dysplasia
and cervical cancer patients treated at Texas Tech University Health Sciences Center
at El Paso (Texas Tech Health El Paso) from 2010-2021. Archived biopsy specimens will
be evaluated for HER2/neu expression using immunohistochemistry staining. Additionally
chart review will be performed to correlate clinical features of the disease. Endpoints
of this study will include evaluation of HER2/neu expression as well as correlation
with clinical characteristics of disease including grade, stage, and disease response
to treatment.
The Role of Incorporating video Aids into Informed Consent for Hysterectomy
Description
Health literacy results from the interaction between the healthcare system and the
individuals in it. As healthcare providers, we are responsible for implementing tools
and strategies to improve the comprehension of our patient population. During the
consent process for a hysterectomy, the surgical removal of the uterus, physicians
discuss several important components of care that are essential for surgical candidates
to understand, such as the reason for the procedure, the risks involved, the benefits
of the surgery, and other treatment options Our study explores whether adding a video
presentation to the consent process for a hysterectomy will improve patient understanding
of the procedure they will undergo, what their options are, and their postoperative
satisfaction.
Utility of a Mindfulness-Based mobile application for Women with Overactive Bladder
and Depression
Description
Overactive bladder (OAB) is a chronic condition that involves urinary urgency/frequency
and nocturia, with or without urgency urinary incontinence, in the absence of urinary
tract infection or other obvious . There is also evidence that depression and anxiety
symptoms may be more prevalent in underserved (predominantly Latina) patients seeking
care for urinary incontinence. Mindfulness-based mobile apps may, therefore, prove
beneficial in some low-resource areas (such as the southern U.S. border) where there
is a growing need for improved access to care and patients have issues with cost,
transportation to frequent weekly sessions, and embarrassment about going out in public
due to severe OAB symptoms. The purpose of this study is to first describe the prevalence
of depression/anxiety in our patients with OAB and then to perform a pilot study investigating
the impact of using a mindfulness-based mobile app in a subset of women with OAB.
Physician vs Patient (Self) Administered Ferriman Gallwey Score and its Relation to
Androgen Levels: A Prospective
Description
Hirsutism is defined as the development of excessive terminal hair growth in a male
pattern distribution in women and it affects approximately 5-8% of the population.
PCOS, the most common cause of hyperandrogenic hirsutism, is a heterogeneous disorder
characterized by hyperandrogenism and chronic anovulation that is associated with
multiple comorbidities including metabolic syndrome, depression, infertility, and
obesity (Lumezi, 2018). While there are multiple scoring systems to evaluate hirsutism,
the current gold standard is the modified Ferriman-Gallwey (mFG) scoring system. This
system can be subjective and has limitations when considering ethnicity, race, genetics,
grooming tendencies, and who is performing the survey. By correlating the physician
scores with the patient self-reported scores to androgen levels and analyzing which
score is most accurate at determining the degree of elevated androgen, this scoring
system could be best optimized to the management and treatment of an adolescent female
patient suffering from hirsutism.
Study of ovarian cancer biomarker
Description
Ovarian cancer is the deadliest gynecological disease that accounts for approximately
140,000 annual female deaths worldwide and because of the ovarian cancers’ highly
aggressive nature, the overall survival rate in ovarian cancer patients remains poor
despite of recent advances in targeted therapies. We have identified a novel player
doppel in tumors and found that doppel collaborates with tumors in creating new blood
vessels for them by controlling the actions of VEGF. Since this protein does not express
and has no known function in female reproductive organs, we now propose to study the
applicability of doppel as a therapeutic biomarker in epithelial ovarian cancer.
Effect of the phthalates exposure on sex steroid hormones in the Hispanic females
having menstrual irregularities
Description
Several studies have suggested that women with irregular menstruation have a higher
concentration of phthalate plasticizers than women with regular cycles. Irregular
menstruation is commonly associated with polycystic ovary syndrome (PCOS). Additionally,
new data demonstrate irregular menstruation is associated with disrupted androgen.
Underlying mechanisms associated with phthalate concentrations in women with irregular
menstruation are not clearly understood. Reconciliation of this knowledge gap and
perhaps determining the association of androgen with phthalates would significantly
advance the field in providing screening algorithms to provide therapeutic advancements
in reproductive endocrinology.
Association between Vaginal pH on Cervical Dysplasia
Description
A study by Teng et al showed a negative correlation between vaginal pH and CIN3+.
This could be due to the understanding that increased vaginal pH leads to a decrease
in natural epithelial defense mechanisms such as defensins which are antimicrobial
peptides and prevent pathogenic proteins from binding to female genital tract cells.
There is a gap in the literature examining an association between vaginal pH and cervical
dysplasia. The goal of this study would be to demonstrate a relationship between high
vaginal pH and high-grade cervical dysplasia.
Evaluating menopausal symptoms in a border population in west Texas
Description
Menopause is a natural event that occurs in the life of all women. The field of menopause
management is a relatively new field and our understanding of issues surrounding menopause
is still limited and is evolving as data from new studies are published. Most of the
studies on menopause so far have been conducted in women of European ethnicity and
the findings have been generalized to women of all However, we know that the experience
of menopause, symptoms and concerns of women vary between women of different ethnicities
due to a variety of causes. The purpose of this study is to gain a better understanding
of the issues surrounding menopause in our patient population that is comprised primarily
of women of Hispanic ethnicity. This better understanding of menopausal issues in
Hispanic women will enable us to develop effective management strategies for these
patients.
Evaluating cross-border reproductive healthcare practices in El Paso, TX
Description
Communities along both sides of the U.S.-Mexico border are closely connected, with
members of either side crossing frequently for work, pleasure, and other activities,
including medical care. Members of border communities are well aware of the practice
of seeking medical care on the opposite side of the border, with practitioners citing
logistics, financial considerations, convenience, and personal preference all as reasons
to seek care in the country one does not reside in. This study seeks to clarify what
access to reproductive healthcare patients have, using specific metrics related to
contraception, to determine if: patients have adequate care in the United States alone;
patients have adequate care but seek some reproductive healthcare services in Mexico
out of personal preference; patients have incomplete or inadequate care in the United
States and seek reproductive healthcare services in Mexico to fill a gap in care.
Implementing learning tools into an integrated longitudinal curriculum
Description
An OBGYN handbook provided to medical students during their third and fourth years
of medical school may help students feel more prepared and confident during their
OBGYN rotation. This study aims to explore the potential benefits of such a handbook
by administration to medical students of a pre- and post- behavioral confidence survey.
Supervisory faculty and residents will also receive a pre- and post- survey in order
to analyze if there is a difference in the perception by faculty and residents who
oversee the medical students in the levels of their confidence and preparedness.
Association of women with clinical features of Polycystic Ovarian Syndrome (PCOS)
to a higher prevalence of having biological children diagnosed with neuropsychiatric
disorders (NPD)
Description
This study aims to investigate if there is a higher prevalence of neuropsychiatric
disorder affected children in women with polycystic ovarian syndrome (PCOS) or clinical
features of PCOS. The evidence of PCOS is the highest in Hispanic females, with an
average of 12% as compared to a 6% national average. We developed a survey questionnaire
for mothers who have PCOS or clinical features of The survey asks about their children
and any neuropsychiatric diagnoses that they may have had. This study would help us
establish a possible association between PCOS and neuropsychiatric disorder diagnosed
biological children, and allow us to explore any possible reasons for this link.
Perception Regarding Tdap Vaccination during pregnancy among women living on the US-Mexican
border
Description
Bordetella Pertussis (also called whooping cough) is a highly contagious disease that causes severe coughing.Whooping
cough is most dangerous for infants under 6 months old, who cannot be fully vaccinated.
In order to protect infants from getting whooping cough, Tdap vaccine is recommended
to pregnant women. Vaccinating pregnant patients is a strategy to protect newborns
from pertussis before they are fully We would like to evaluate the knowledge and attitudes
of pregnant women towards maternal vaccination to protect newborns against Bordetella Pertussis.
Pessary specific didactic and simulation to improve resident knowledge and comfort
with pessary placement
Description
Vaginal pessaries are flexible silicone devices in various shapes used by OB/GYNs
to treat pelvic organ prolapse in women such as uterine, bladder or rectal prolapse.
Despite their common use, many residents and physicians report feeling that they lack
knowledge and training on pessary placement. The purpose of this study is to determine
if a pessary specific didactic training session improves resident knowledge and comfort
in placing A pre and post questionnaire will be used to assess resident knowledge
and perception of comfort. The questionnaire will be redistributed 6-months post-
didactic to evaluate long-term effect of the didactic session.
