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April 7, 2008, 10:35 PM CT

Your baby's brain on drugs

Your baby's brain on drugs
Eventhough behavioral studies clearly indicate that exposure to drugs, alcohol and tobacco in utero is bad for a baby's developing brain, specific anatomic brain effects have been hard to tease out in humans. Often users don't limit themselves to one substance, and demographic factors like poverty can also influence brain development.

Now, an NIH-funded study using magnetic resonance imaging (MRI) brain scans, led by Children's Hospital Boston neurologist Michael Rivkin, MD, suggests that prenatal exposure to cocaine, alcohol, marijuana or tobacco (alone or in combination) may have effects on brain structure that persist into early adolescence. The findings, reported in the recent issue of Pediatrics, are of public health significance, the scientists say, since it's estimated that more than 1 million babies born annually in the United States have been exposed to at least one of these agents in utero.

Scientists at Children's and Boston Medical Center employed volumetric MRI imaging to study the brain structure of 35 young adolescents prenatally exposed to cocaine, marijuana, alcohol or tobacco. The children, who averaged 12 years old at the time of imaging, were part of part of an historic cohort of children assembled by Deborah Frank, MD at Boston Medical Center and followed there since birth. Prenatal exposures were confirmed by a combination of maternal history, urine testing of the mother or urine or meconium (stool) testing of the infants at birth.........

Posted by: Emily      Read more         Source


April 3, 2008, 8:18 PM CT

Continuous oral contraceptives better at easing pain, bleeding

Continuous oral contraceptives better at easing pain, bleeding
Continuous oral contraceptives may be more effective than the standard 28-day birth control pills in suppressing the ovary, as per researchers. They say that the continuous pill also causes a significant improvement in pain and behavioral changes.

"We have provided a biological proof of concept that both the ovary and the lining of the uterus are suppressed better and quicker with the continuous pill than with the cyclic pill. And there is no harmful effect on the lining of the uterus either," said Richard Legro, M.D., professor of obstetrics and gynecology, Penn State College of Medicine and lead author of the study.

Standard 28-day birth control pills mimic a woman's natural menstrual cycle, while preventing pregnancy. A standard dose includes 21 hormone pills to suppress growth in the endometrium, the lining of the uterus, and seven placeholder placebo pills.

Continuous oral contraceptives may be more effective in treating several medical conditions, where continuous ovarian suppression is desired, such as acne, hirsutism, premenstrual syndrome, endometriosis and polycystic ovary syndrome. But there have been few detailed studies of ovarian function on the pill to demonstrate this effect.

Legro and colleagues compared the effectiveness of continuous oral contraceptives with that of the cyclical pills. The scientists monitored 62 healthy women, randomly assigned to receive either cyclical or continuous birth control pills, for six months with both scientists and participants blinded to the study group.........

Posted by: Emily      Read more         Source


March 27, 2008, 9:42 PM CT

Being born bottom first is inherited

Being born bottom first is inherited
A baby is twice as likely to be born bottom first if either or both the parents were themselves breech deliveries, as per a research studypublished ahead of print on bmj.com. The results suggest genes are a contributing factor.

The vast majority of babies are delivered head first. Fewer than one in twenty are delivered the other way round what is known as a breech delivery. Such deliveries carry significantly greater risks for the baby: they are more likely to die or suffer from health problems.

Factors such as premature delivery and low birth weight are also known risk factors linked to a breech delivery but these only account for up to one in seven of all such breech births. Until now knowledge of whether genes could also be a factor has been lacking.

The scientists from the University of Bergen in Norway looked at data covering all the births in Norway between 1967 and 2004. They studied the information available on men and women and their first born children - a total of 387,555 parent and child units.

They observed that men and women who had been delivered full-term in breech had more than twice the risk of breech delivery in their own first pregnancies. Furthermore, babies delivered naturally, not by caesarean, were at the biggest risk of a breech delivery.........

Posted by: Emily      Read more         Source


March 24, 2008, 7:55 PM CT

The surprising power of the pill

The surprising power of the pill
Dr. Haim Pinkus
Women who have tried to conceive using in vitro fertilization (IVF) methods are painfully aware that timing is of the essence. There are cancelled vacations, too a number of sick days taken from work, and the necessity to plan everything around the therapy.

But thanks to a Tel Aviv University study, trying for a baby has just been made easier. In a surprising finding, scientists have discovered that the same pill used to prevent pregnancy can actually help a woman conceive.

Dr. Haim Pinkas MD, a senior doctor at the Rabin Medical Center and an academic staff member of Tel Aviv Universitys Sackler School of Medicine, and colleagues at the infertility center where he practices, have observed that a two-week intervention therapy using a standard low-dose birth control pill can help time egg harvesting, making the IVF process more convenient for both doctor and patient.

The study was done on 1,800 women at the Infertility and IVF Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva and appeared in the Journal of Assisted Reproduction & Genetics in January of this year.

All in the Timing

As per the American Fertility Association, more than 15% of American couples have difficulty conceiving a child. There are currently two types of treatment natural methods and assisted reproductive techniques such as IVF. In a number of cases, IVF offers the last hope to conceive a child.........

Posted by: Emily      Read more         Source


March 11, 2008, 10:10 PM CT

Revise guidelines for weight gain during pregnancy

Revise guidelines for weight gain during pregnancy
Current recommendations for weight gain during pregnancy developed by the Institute of Medicine (IOM) in 1990 should be revised, as per an internationally recognized obesity expert and chairman of the department of obstetrics, gynecology and womens health at Saint Louis University.

The editorial by Raul Artal, M.D., who has conducted extensive research on obesity during pregnancy, appears in the recent issue of Expert Review of Obstetrics and Gynecology, an international medical journal.

Recommendations by the IOM, which are followed worldwide by obstetricians, encourage obese women to gain at least 15 pounds during pregnancy and specify no upper limit for weight gain. The IOM is a panel of national experts who provide advice on medical and health issues.

Overweight or obese women dont need to gain that much weight and should exercise and watch their calorie consumption during pregnancy, Artal said.

Pregnancy has become over the years a state of indulgence and confinement, he wrote. Pregnancy is an ideal time for behavior modification that includes physical activity and with proper medical supervision it can be safely prescribed.

The IOM guidelines were not grounded in scientific evidence, Artal said, and focused primarily on preventing low birth-weight deliveries, which generally occur when women who are underweight and of normal weight dont gain enough weight during pregnancy.........

Posted by: Emily      Read more         Source


March 4, 2008, 4:16 PM CT

After cessation of postmenopausal hormone therapy

After cessation of postmenopausal hormone therapy
The Womens Health Initiative (WHI) scientists have produced another article [1], which probably marks the opening of another set of publications, in which the consequences of a further 2.4-year follow-up (after cessation of the study medication) on the estrogen + progestogen (E + P) cohort are reported. They concluded that, by the end of the post-intervention period, the global index, a newly formed and unvalidated tool used in the WHI trial, was still higher in women randomly assigned to receive E + P compared with placebo.

After such long and painful debates over the results of the WHI study and the perception that age is a very important determinant of the benefitrisk evaluation, it is really a pity that once again the current information on the extended follow-up period is presented in an unsatisfactory way, says Professor Amos Pines, the President of the International Menopause Society. It seems that the following mistakes were repeated:
  1. There is no mention of the results by age groups and yet, for the age group 5059 years, the data recorded for the active phase of the WHI E + P arm showed no significant increase in risk of coronary events, strokes and breast cancer in the early postmenopause period. Also, there is no breakdown of the data by years of follow-up. It would be extremely important to know whether the results for the first year post cessation of therapy are similar to those for year 2 and year 3 of follow-up.
  2. ........

    Posted by: Emily      Read more         Source


February 25, 2008, 9:01 PM CT

Mother's antibody production may affect fetal brain

Mother's antibody production may affect fetal brain
The mothers of some autistic children may have made antibodies against their fetuses brain tissue during pregnancy that crossed the placenta and caused changes that led to autism, suggests research led by Johns Hopkins Childrens Center researchers and reported in the recent issue of the Journal of Neuroimmunology.

The causes of autism, a disorder manifesting itself with a range of brain problems and marked by impaired social interactions, communication disorders and repetitive behaviors, remain unknown for an estimated 90 percent of children diagnosed with it. Genetic, metabolic and environmental factors have been implicated in various studies of autism, a disorder affecting 1 in 150 U.S. children, as per estimates by the Centers for Disease Control and Prevention.

Now our research suggests that the mothers immune system may be yet another factor or a trigger in those already predisposed, says lead investigator Harvey Singer, M.D., director of.

pediatric neurology at Hopkins Childrens.

Scientists caution that the findings neednt be cause for alarm, but should be viewed instead as a step forward in untangling the complex nature of autism.

Mostly anecdotal past evidence of immune system involvement has emerged from unusual antibody levels in some autistic children and from postmortem brain tissue studies showing immune abnormalities in areas of the brain. Antibodies are proteins the body makes in response to viruses and bacteria or sometimes mistakenly against its own tissues. Yet, the majority of children with autism have no clinical evidence of autoimmune diseases, which prompted scientists to wonder whether the antibodies transferred from mother to child during pregnancy could interfere with the fetal brain directly.........

Posted by: Emily      Read more         Source


February 4, 2008, 9:39 PM CT

Women prefer contraceptive ring over patch

Women prefer contraceptive ring over patch
In the first study to directly compare a contraceptive vaginal ring and skin patch, more women indicated overall satisfaction with the vaginal ring, scientists report in the current issue of Obstetrics and Gynecology, a publication of the American College of Obstetricians and Gynecologists. Using the same combination of hormones included in prescription birth control pills, these products became available in 2002 as an alternative to taking a pill every day. Ring and patch are left in place for three weeks at a time.

The study reviewed the experiences of 500 women who were randomly assigned to use the ring or patch for four consecutive menstrual cycles in 2005 and 2006. Of these, 249 used the ring and 251 used the patch. In addition to regular study visits for physical evaluation, participants completed a questionnaire and talked to researchers by phone following the study period.

What we found is that more women are happier with the ring than the patch, said Mitchell Creinin, M.D., professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine and the studys first author. On the whole, they report fewer complications, and a significant majority preferred the ring to their pill. The University of Pittsburgh served as sponsoring institution for the trial, which was conducted at 10 centers nationwide.........

Posted by: Emily      Read more         Source


January 31, 2008, 8:56 PM CT

African-Americans less likely to choose epidurals

African-Americans less likely to choose epidurals
Minority and low-income patients are less likely than those who are white or more well off to agree to post-surgery epidural pain relief, as per new research from physicians at the University of Pennsylvania School of Medicine. The study, published recently in the journal Anesthesia and Analgesia, examined how race, economic and educational status may influence health care choices when access to care isnt a factor. In the overall analysis, education and income were not as important as race in determining epidural acceptance, but the scientists say the costs of improper pain therapy after surgery are large for any patient group.

Epidurals are more effective for relieving postoperative pain, and higher levels of pain have been associated with the development of chronic pain, says E. Andrew Ochroch, MD, an associate professor and director of clinical research in the Department of Anesthesiology and Critical Care. Consequently, if African Americans are either denied or denying themselves epidural for pain relief, then they may be at greater risk for postoperative complications.

Patients who receive perioperative epidural analgesia during major upper abdominal or chest surgery, for instance, have improved lung function, which reduces their risk of pneumonia. And since theyre able to get out of bed to move around sooner, theyre primed to go home sooner than those who have severe pain. Research also shows that patients who have high levels of perioperative pain are more apt to suffer from chronic pain later on.........

Posted by: Emily      Read more         Source


January 21, 2008, 8:48 PM CT

Caffeine's link to miscarriage

Caffeine's link to miscarriage
High doses of daily caffeine during pregnancy whether from coffee, tea, caffeinated soda or hot chocolate -- cause an increased risk of miscarriage, according a new study by the Kaiser Permanente Division of Research. The study controlled, for the first time, pregnancy-related symptoms of nausea, vomiting and caffeine aversion that tended to interfere with the determination of caffeines true effect on miscarriage risk. The research appears in the current online issue of American Journal of Obstetrics and Gynecology.

While prior research showed a link between caffeine consumption and miscarriage, this is the first study to thoroughly control for morning sickness, which typically causes a number of women to avoid caffeine, explained De-Kun Li, MD, Ph.D., an investigator with the Kaiser Permanente Division of Research and lead investigator of the study. This study strengthens the association between caffeine and miscarriage risk because it removes speculation that the association was due to reduced caffeine intake by healthy pregnant women, Li said.

To address that speculation, the study, which looked at 1,063 pregnant Kaiser Permanente members in San Francisco from October 1996 through October 1998, examined the caffeine effect among women who never changed their pattern of caffeine consumption during their pregnancy. Kaiser Permanente is the nations largest health plan with 8.7 million members, 416 medical offices and 32 hospitals in nine states and the District of Columbia.........

Posted by: Emily      Read more         Source



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Did you know?
The addition of testosterone to hormone therapy in women after menopause enhances their sexual function. However, it may also reduce HDL cholesterol (the "good" cholesterol) in women, according to a systematic review of current evidence."If the reduction in HDL had been associated with an increase in triglycerides [fatty acids] or LDL cholesterol it would be of great concern," said Dr. Susan Davis, professor of medicine at Monash University, Melbourne, Australia, and study co-author "However, as an isolated finding the significance is difficult to interpret." She added, "Testosterone has not been found to alter other coronary heart disease risk factors.".

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