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Chronobiology Research Finds More Effective Treatment for Rheumatoid Arthritis 

January, 2022

Rheumatoid arthritis (RA) is one of the most common forms of autoimmune arthritis, and treatment measures for this condition usually begin with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. These work to decrease inflammation, relieve pain and increase mobility in patients, and while they may aid in easing discomfort, short term, they do not treat the root cause of the disease. Upon official diagnosis, many patients may be recommended to begin treatment using disease-modifying antirheumatic drugs (DMARDs). This category of medication is specifically meant to help slow the progression of the disease. However, it does not always stop or reverse the effects of RA on the body, and eventually, the effects of this disease can become severe enough that an individual is referred to receive treatment using biologics. Research, however, shows promising results in considering biologics, or chronotherapy, early on, to prevent the escalation of the disease. A Closer Look at Rheumatoid Arthritis It should be understood that this autoimmune disease manifests as inflammation in one or more joints between the bones, usually separated by tough cartilage. As an autoimmune and inflammatory disease, the immune system attacks healthy cells in the body by mistake, which leads to painful swelling, stiffness, pain, and loss of joint movement in the affected joints, typically those in the hands, wrists, and knees. In severe cases, RA can also affect other tissues throughout the body and lead to problems in organs such as the lungs, heart, and eyes. It is guesstimated that rheumatoid arthritis affects more than 1.3 million Americans, and over one percent of the population worldwide. One alarming fact about onset of this condition is that about 75 percent of all cases are found in women versus men. The Importance of Chronobiology Chronobiology is the study of biological rhythms over the course of the day and night, and how they affect the body’s functions and overall health. Among the many avenues of chronobiology study, this research has found that certain diseases, such as rheumatoid arthritis, are more severe at particular times of the day. While it was initially believed that this type of research would provide physicians with a better way to diagnose and treat rheumatoid arthritis patients, researchers began to realize their findings shared more than simply a better way of diagnosing and treating the disease; chronobiology also helped to understand the root causes of many autoimmune diseases. What Chronobiology Revealed About Rheumatoid Arthritis The first discovery that chronobiology provided to physicians came from applying what they knew about circadian rhythms to rheumatoid arthritis. This research began to reveal that people with this disease were more sensitive to the cortisol hormone, which is released in response to stress or fear during times of darkness. Furthermore, when these patients' cortisol levels were at their highest, they experienced greater pain and stiffness in their joints. It was also discovered that, in these patients, cortisol levels reached their maximum throughout the night while participants were sleeping. During this discovery, physicians began to finetune their chronobiology research and noticed that some autoimmune diseases had more severe symptoms during specific periods of the day. They hypothesized that this might be due to different biological processes being active at different times and what they discovered was that many autoimmune disorders were caused by pathogenic proteins activated during certain times of the day. Rheumatoid arthritis was discovered to be one of the autoimmune diseases in which these protein molecules activate at different times, leading to increases in pain. By identifying the root cause of RA causes and flare-ups, new approaches to therapy and treatment with chronobiological approaches paved the way to better outcomes for patients. Applying Chronobiology Findings to RA Treatment Through RA research, it was discovered that Chronobiology could help treat rheumatoid arthritis by focusing on therapies to rebalance patients' circadian rhythms. There are two principal ways of doing this; the first is known as chronotherapy. Chronotherapy involves administering RA and hormone medications during certain times of the day that will help balance patients' biological clocks by rebalancing their cortisol levels. Through the rebalancing of cortisol levels, the discovered nighttime spikes that led to greater RA pain could be managed and even reduced. On the other hand, the second practice is referred to as chronotherapeutic approaches, which aims to alter the physical environment of patients, to help rebalance their biological clocks. One particular chronotherapeutic approach that may help treat rheumatoid arthritis is known as light therapy. This type of treatment involves turning on bright lights when it would naturally be dark for patients' biological light-dark circadian rhythm cues. These bright lights are thought to help reset patients' biological clocks to promote healthy cortisol levels, to reduce the severity of symptoms. Despite the research and findings regarding the role chronobiology and circadian rhythm cues play on RA symptoms and hormone surges, these types of treatment are not widely used yet due to a lack of mainstream and general understanding of chronobiology and, though significant, its limited research. While the science of chronobiology is still relatively new, cutting-edge field used sporadically in the healthcare industry, it’s research and understanding is growing among universities, and medical professionals and researchers. With the tremendous amount of information hidden in this very advanced science, it has the potential to become one of the most important research topics in the medical fields. In regards to patients dealing with RA, there are results that indicate chronobiology-formulated treatments could become an effective way to manage rheumatoid arthritis for patients who do not respond well to conventional treatments.

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Avoiding Chemical Based Feminine Hygiene Products for Improved Fertility

November, 2022

When it comes to fertility concerns, chemical-based feminine hygiene products might explain why some women are unable to conceive. According to a study published by the Centers for Disease Control and Prevention (CDC), around 10 percent or roughly 6.1 million American women in the U.S. between the ages of 15 and 44 have difficulty getting pregnant or staying pregnant. For some of these women, such struggles amount to bad luck. For others, however, the issue stems from health-related issues such as polycystic ovarian syndrome (PCOS) or endometriosis, and lifestyle choices. Among the lifestyle factors, available data shows that exposure to some everyday products can drastically reduce a woman's chances of conceiving and one day becoming a mother. While most women are aware of staying away from certain products that are known to contain carcinogens. After all, not only can avoiding such chemicals aid in fertility health but doing so also helps lower their chances of developing cancer. However, few women are as diligent about staying clear of products that contain other harmful ingredients that cause infertility in women. Some of the products that can ruin a woman's chances of getting pregnant, giving birth, and ultimately raising a child include: •Fruits and vegetables canned in tins lined with bisphenol A (BPA) •Nail polish, perfumes, deodorants, and hair gels that contain harmful phthalates, retinoids or acetone •Oil-based paints, paint thinners, and painting supplies containing lead or mercury •Scrubs, soaps, and creams that contain estrogen-like parabens Another of the many chemicals that can trigger infertility in women is commonly found in feminine hygiene products. Yes, the same products that most women use to manage the symptoms brought on by their monthly menstrual cycle can, according to some studies, negatively impact women’s fertility health. Steering Clear of Chemical-Based Feminine Hygiene Products Although the medical and scientific communities have known for years that exposure to BPAs, parabens, mercury, and lead can trigger infertility in women, they only recently discovered that many feminine hygiene products currently on the market may contain many of them. Some of the biggest offenders, they found, were tampons, douches, and deodorant powders. These products, researchers said, contain harmful chemicals that either preclude women from becoming pregnant or put them at risk of developing a host of chronic diseases, cancer being one of them. Anti-itch creams, found to commonly contain chemical allergens or irritants can exacerbate the very symptoms that women are attempting to treat with them, while many feminine care products contain formaldehyde-releasing preservatives, and formaldehyde, which is a carcinogen and a potent allergen. Additionally, many feminine washes contain ingredients deemed by the FDA to be safe “for external use only,” however as the feminine wash is used, is inevitably in contact with internal areas. When it comes to tampons that are used internally, the most commonly known ingredients include cotton, rayon, polyester, propylene, polyethylene and fiber finishes. When it comes to these fiber finishes or fragrances however, many companies remain vague about the ingredients. The ultimate reasoning for exposing many of these ingredients was due to the severe risk of death due to Toxic Shock Syndrome (TSS). TSS is a bacterial infection that has been linked to making tampons more absorbent, thus warning labels tend to state that “the risk of TSS increases with higher absorbency.” Some of the additional chemical ingredients that may be present in feminine hygiene products and pose a risk to women’s fertility health include the following: Phthalates – Among other things, phthalates have been associated with reproductive toxicity that can cause reproductive and neurological problems in women. This infertility-causing chemical is in nail polish, perfumes, deodorants, hair gels, shampoos, lotions, and hand sanitizers, is also found in many sanitary napkins and feminine products. One study found that phthalates were present in 86 percent to 98 percent of feminine care products and sanitary napkins, respectively, with the total concentrations varying between not detectable and 813 μg/g. When compared to normal phthalate exposure, sanitary napkins contributed to 8.2 percent of women’s total exposure; presenting higher than those reported from air ingestion but lower than those from dietary intakes. Formaldehyde - Formaldehyde, is a toxic chemical that is not only linked to cancer but also infertility and miscarriages. As mentioned above, most douche products and feminine wipes have been found to contain formaldehyde-releasing preservatives such as Diazolidinyl urea, DMDM Hydantoin, Quaternium-15, 2-Bromo-2-Nitropropane-1, 3-Diol and Polyoxymethylene Urea, and thus formaldehyde itself. Octoxynol-9 –Available data shows that prolonged exposure to octoxynol-9 can trigger the onset of genital irritation, increased vaginal discharge, and reproductive toxicity. Additionally, it functions as a spermicide, which is counterproductive when trying to conceive. Studies have shown this chemical is found in many douche products and feminine wipes. Pesticides and Herbicides - These known carcinogens and endocrine disruptors are used on conventional cotton crops and have been associated with interfering with female hormonal and ovarian function and fertility. Ultimately, feminine hygiene products containing non-organic cotton is comprised of these fibers that have been sprayed by pesticides and herbicides; 7, of the top 15, of which been declared by the Environmental Protection Agency (EPA) as known human carcinogens. Other chemicals and products worth noting include: Lead – According to the World Health Organization, too much exposure to lead can adversely affect multiple body systems, including the brain, liver, kidney, and bones. Such issues can severely impact a woman's fertility and overall health. Studies show over 61 percent of lipsticks currently on the market contain lead. Petroleum Jelly – For those unaware, many lubricants and moisturizers that women naturally reach for when they want to get intimate or care for down there, contain petroleum jelly. The concern is that petroleum jelly contains polycyclic aromatic hydrocarbons (PAHs), which can destroy male sperm and put women at risk of developing breast and other cancers. But it does not end there; some studies show a nexus between petroleum jelly and damage to a woman's reproductive organs and fertility. Thus, opting for fertility-friendly and natural lubricants is the suggested option. Better Feminine Care Product Alternatives: While there are less commonly known, there are several healthy natural feminine care products available on the market. Some chemical-free alternative options include reusable pads and cups. Additionally, thought coming in at a generally higher price than more common products, there are a number of disposable items made with non-GMO organic cotton that contain no dyes, fragrances, fibers or plastic applicators. All in all, multiple beauty, household, and feminine hygiene products can trigger fertility issues in women, thus the importance of reading labels and looking for natural alternatives when possible that can help limit exposures. Many alternatives are free of harmful chemical ingredients that are known to cause disease and interfere with fertility. For some women, making these types of modifications in product preferences can help improve the chances of conceiving.

A Complete Guide to Ectopic Pregnancy

July, 2022

For some women, the idea of an ectopic pregnancy is a conceptual diagnosis that has never come to mind, for others it is a very real concern. Here, we cover the symptoms, diagnosis, and treatment of ectopic pregnancy, including the causes and who might be at risk. Also known as tubal pregnancy, an ectopic pregnancy is relatively rare, occurring in about 1 of every 50 pregnancies. A diagnosis of which can be emotionally difficult for any woman trying to get pregnant, as pregnancy concerns as well as concern for maternal safety come into play. In short, a diagnosis means the fertilized egg isn’t able to survive and develop to full term, and the main focus shifts to maternal health and wellbeing due to the severity of risks if left untreated. What Is an Ectopic Pregnancy? This condition occurs when an embryo implants somewhere in the body other than the uterus, typically taking place in the fallopian tubes. During a typical pregnancy, once fertilized, a newly-formed embryo will stay in the fallopian tube for about three to four days. After this time period, the embryo will travel from the fallopian tube and implant into the lining of the uterus where it continues to develop into a healthy fetus. With an ectopic pregnancy however, the embryo forms and then implants in the fallopian tube. In more rare cases it is possible that the embryo will implant in the cervix, ovary, or abdominal cavity. While implantation does occur, because it does not occur in the uterus where pregnancy takes place, the embryo cannot properly develop, and moreover, the pregnancy can’t continue naturally due to the health risks that arise to the mother. When diagnosed, this condition must be treated as a medical emergency requiring urgent attention, as life-threatening risks to the mother, from infection and/or a ruptured fallopian tube, begin to rise if the condition is left untreated. Causes and Risk Factors When it comes to an ectopic pregnancy, in most cases, this condition is caused by a blockage or inhibited movement of the egg through the fallopian tube. This can be due to infection or inflammation in the fallopian tube or the presence of cysts or other mass. The most common cause of ectopic pregnancy is the condition of pelvic inflammatory disease (PID), which affects more than 1 million women in the United States each year, and can result in scar tissue formation that hinders the movement of the egg through the fallopian tube. Additionally, polycystic ovarian syndrome (PCOS), which affects one in five women, is another possible cause of ectopic pregnancy as it can lead to cyst formation that blocks the fallopian tube pathways. This condition has a number of risk factors associated with it and is more likely to occur in women who: Have a history of sexually transmitted diseases Have had an unsuccessful tubal ligation procedure, or have had a tubal ligation reversal procedure Have a history of pelvic inflammatory disease (PID) Have previously had an ectopic pregnancy Have previously had pelvic surgery Smoke Have endometriosis Have polycystic ovarian syndrome (PCOS) Have conceived while an intrauterine device (IUD) is in place Undergo fertility treatments and/or are using fertility drugs In each case of ectopic pregnancy, it’s difficult or impossible to tell the exact cause of the failed implantation into the uterus, and in all cases of ectopic pregnancy, there is no preventative measure that could have been taken to prevent this condition from occurring. Symptoms and Diagnosis When an ectopic pregnancy occurs, the first signs of this condition may present itself in the form of pelvic pain, with or without bleeding. Other common symptoms include: Abdominal cramping, which is often severe and may be sharp or stabbing Pain in the pelvis, neck or shoulder, due to blood pooling under the diaphragm after a rupture Breast tenderness Vaginal bleeding, heavy or light in severity Dizziness Gastrointestinal issues Nausea, accompanied by pain Vomiting, accompanied by pain Weakness Fainting Symptoms of ectopic pregnancy should be diagnosed by a health care practitioner immediately, thus it is essential that if any of the symptoms are present or you are concerned about an ectopic pregnancy, your doctor be contacted immediately for evaluation. If heavy vaginal bleeding accompanied by fainting, lightheadedness, and pain are present, it is vital that you visit an emergency treatment facility immediately, as these are symptoms of a potential ruptured fallopian tube and will need to be treated as a medical emergency. During routine exams or emergency screenings, an ectopic pregnancy is diagnosed with a pelvic exam to locate the source of the pain. Additionally, an ultrasound may be performed to ensure the fallopian tubes have not ruptured and to determine the condition of the uterus. A pregnancy or blood test may also be given to measure hCG and progesterone levels and determine if they are within normal range or have dropped, as low levels could be a sign of an ectopic pregnancy. In addition, your physician may choose to perform a culdocentesis, a procedure in which a needle is inserted behind the uterus at the very top of the vagina and in front of the rectum. The culdocentesis procedure checks for the presence of blood in this area, which can indicate bleeding from a ruptured fallopian tube. Treatment Treatment of an ectopic pregnancy is determined based on how far the condition has progressed and how severe symptoms currently are, however medication or surgery are the only options. In the early stages of an ectopic pregnancy, a doctor can inject a medication called methotrexate, which may also be referred to by the brand name Trexall. This methotrexate medication prevents the cells of the embryo from developing any further, and in most cases the cells are reabsorbed by the body. In many cases of ectopic pregnancy, this medication is the viable treatment. For those receiving a single dose of the medication, the average time for resolving an ectopic pregnancy is approximately 32 days, while it may take up to 58 days for those women who receive two or more doses. Ectopic pregnancies that are further along or if the fallopian tube has stretched, ruptured, or has begun bleeding, a surgery will need to be performed to remove the part or all of the fallopian tube. In many cases, laparoscopic surgery is possible, using only a small incision in the lower abdomen. During this surgery a surgeon will remove the ectopic pregnancy and repair or remove the affected fallopian tube. If the unaffected fallopian tube looks healthy, surgeons will generally remove the entire affected fallopian tube, however trying to remove the pregnancy without removing the whole tube may be attempted. After surgical treatment, your doctor will perform a blood test to looks for hormone changes that indicate pregnancy to confirm that the pregnancy has ended so you are no longer at risk for serious and even life-threatening issues. Future Pregnancies Most women who have experienced an ectopic pregnancy are able to have a healthy pregnancy afterward, even in cases where one fallopian tube was completely removed. Some health care providers recommend waiting for three to six months before trying to get pregnant again, and your doctor or health care provider may also recommend visiting a fertility specialist before trying again. Although removal of one fallopian tube may make it more difficult to get pregnant again, it is still possible. For women who have previously been treated for an ectopic pregnancy, there is a 10 percent risk of recurrence, which is why it’s important to work with your doctor and healthcare team when planning for a future pregnancy.

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Understanding the Increased Prevalence of Osteoarthritis in Women

January, 2022

When it comes to osteoarthritis a number of factors can contribute to this, wearing-away of cartilage between joints. Factors such as aging, weight gain, and injury can all be contributors to this condition, however, due to some distinctive factors, women are twice as likely to develop osteoarthritis than men. When it comes to osteoarthritis onset, research shows that in comparison to men, women are 10 percent more likely to develop hip osteoarthritis, 40 percent more likely to develop knee osteoarthritis, and women between the ages of 50 and 60 may be 3.5 times (350 percent) more likely to develop osteoarthritis in the hand compared to men of the same age group. In addition, there is some additional research that suggests women tend to report the most severe cases of osteoarthritis pain compared to men. So, what’s the cause of the increased risk -- the answer is multi-faceted. Risk Factors Women Have for Osteoarthritis vs Men Though it is one of the most common forms of arthritis, research shows that this condition is not an equal-opportunity disorder, and this heightened risk of the condition is due to a number of factors that are isolated to women including the prevalence of regular fluctuating hormones and body weight distribution, among others. Hormone Fluctuations It’s no surprise that a result of the monthly menstrual cycle, women’s hormones regularly fluctuate throughout their life, increasing exponentially as a result of menopause and normal hormonal decline. As a result of these fluctuations, women have a higher risk of developing osteoarthritis as they get older due to the decrease of the hormone estrogen that occurs in their body. While estrogen helps control the menstrual cycle, it also helps to keep bones strong and healthy by building up the collagen matrix and regulating bone remodeling. The decrease in estrogen as women age weakens the collagen matrix making bones more susceptible to bone and cartilage conditions, such as osteoarthritis. Increased risk of rapid accelerated bone loss after menopause can leave stressed joints more susceptible to inflammation and further breakdown. Due to menopausal impacts on hormones and bone density shifts, research finds that post-menopausal women experience osteoarthritis onset at an earlier age than men, with symptomatic onset of hip osteoarthritis occurring an average of six years earlier for females than males, and clinical onset occurring about five years earlier. Hormonal Replacement Therapy A common treatment option for menopause, hormonal replacement therapy (HRT) can help balance and alter hormone levels in the body, however it can also impact women's bone mineral density, increasing or even improving their risk of developing osteoarthritis. Due to the mimicking of hormonal influence on the body, in some cases HRT can help increase estrogen and balance other hormones to improve bone density while short-term HRT may be associated with an increase in osteoarthritis onset due to hormone instability long-term. Weight Gain and Distribution When it comes to weight gain, according to the National Institutes of Health, US women are almost 41 percent likely to be overweight and obese than men’s 35 percent chance. This increase in obesity increases the risk of osteoarthritis due to the additional weight strain that is put on load-bearing joints, such as the hips, knees, and ankles, leading to increased friction and damage between the joints. Furthermore, when compared to men, women also tend to have less muscle mass around key joints, such as the knees which can lead to instability and a greater chance of sprains and tearing of the ligament if it is overstretched. In addition to weight distributing greater stress on the body’s joints, obesity is also associated with low-grade inflammation throughout the body. This inflammation, in turn can become an additional contributing factor to the development of osteoarthritis in any joint. Musculoskeletal System Differences While men and women have the same joints throughout the body, certain musculoskeletal differences exist between the sexes which tend to alter the way men and women stand, walk, and run. These musculoskeletal differences also tend to alter women’s joint articulation, meaning how the joint surfaces move in relation to one another, causing more wear and tear on specific joints such as the knees and hips, compared to men. In addition, some of women’s joints, such as the knees, contain less cartilage than men’s knees, even when bone size and body mass is taken into account, further leading to an increase in wear and tear and heightening the risk of osteoarthritis. Exercise and Injury When it comes to fitness and activity, one theory concerned with women’s increased risk for osteoarthritis lies in the increase in women participating in sports, and thus the increase in sports-related injuries, of which women are more prone to due to the above musculoskeletal system differences. In particular, tears to the anterior cruciate ligament (ACL), ankle sprains, and stress fractures are more common among women. These types of injuries, even with treatment, can create an increased risk of osteoarthritis over time. Genetics Like many ailments and conditions, genetics can play a significant role in risk factors that contribute to the development of osteoarthritis. While there are a number of factors when it comes to genetic dispositions, research suggests that women who suffer from degenerative joint disease may have a greater chance of passing the disease risk factors to their female children, as there are specific genetic factors that have specific links to knee and hand degenerative joint disease. All-in-all, osteoarthritis can develop in both men and women, but ultimately, women have a higher risk of developing the condition than men. Regardless of hormonal or anatomical differences that increase the risk however, women can take measures to help reduce their risk. How Women Can Lower Their Chance of Osteoarthritis Although women tend to experience more weight gain naturally as they age, maintaining a healthy weight through diet and exercise measures can help prevent obesity and provide one less risk factor that can lead to the development of osteoarthritis. For women undergoing HRT, due to the hormonal fluctuations that impact bone and joint health, it is important to discuss short- and long-term effects on not only hormone treatment options but the overall impact on other biological factors such as bone density. When it comes to physical activity, it is recommended that women focus on strength training, balance, and coordination, as they age, to help strengthen muscle mass and joint strength to protect joints from injury. In addition, low-impact exercises such as swimming, biking, and treadmill walking are great options for women to strengthen muscles and improve joint health with minimal strain. For those women with a family history of osteoarthritis, it is essential to take extra precaution with staying active, maintaining a healthy weight and addressing underlying issues that may increase the risk if needed. By staying active and maintaining overall health and maintaining a healthy lifestyle into later years, bone and joint health can be preserved to some extent and be helpful in the prevention of osteoarthritis and keeping painful symptoms to a minimum.

Spa Indulgences and Everyday Treatments

October, 2012

From times ‘before common era,’ when the Greeks indulged in social baths and extravagant hot bath and activity thermaes were built across the Roman Empire, the water and skin treatments have been prevalent and continued to transform for centuries. While the exact start of spas has an array of speculations, the popularity of modern day spas is apparent. While day spas are known from making your skin feel ‘pretty’, they’re called treatments for a reason. From the ever-so popular practices in Europe and Japan to the indulging participation in America, the benefits are acknowledged and highly sought after. “When it comes to massages, facials and body treatments you’re actually healing something. Massage helps detoxify the body and increasing blood circulation. Facials help slow the aging process and replenish the skin,” said Darlene Purdy, licensed aesthetician and Salon Manager for Euphoria Salon at Boca Park. “While externally it does make you look pretty, internally it’s good for the health the body as well.” When browsing the day spa menus a plethora of options and ingredients are offered but two key components are often found at the top of the list: seaweed and oxygen. The trick to body wraps and treatments is not necessarily found in the general process of covering the skin for a certain length of time, but the essential ingredients used to do so. The ever-popular seaweed body wrap for example is so effective in detoxifying and replenishing the body because of the seaweed used. Purdy points out that the iodine found in seaweed mimics the body’s blood plasma nearly identically. When heated up on the skin, the 104 trace elements found in seaweed work as a catalyst and force essential minerals back into the blood stream while simultaneously detoxifying the body of harmful, built up toxins. Pure oxygen has a similar effect when it comes to the natural effect it has on the body externally. “For oxygen treatments, we spray a vitamin solution onto the skin and then spray pure oxygen over the face. The pure oxygen pushes the vitamins into the skin,” said MaryAnn Phillips, Spa Manager at Parisian Day Spa in Henderson. “With an oxygen treatment you are not only breathing the pure oxygen but your skin is absorbing it as well, which helps to combat free radicals that attack your skin and cause fine lines and aging.” Like any proper maintenance the trick to gaining the best results is a continuous routine. While a twice a year splurge at the day spa may feel like it gives you the best glow you can get, the true benefits are seen with regular applications. When it comes to spa treatments, it’s all about the ingredients. Based on individual skin type, there is no set guideline to how often these treatments should occur, but for the average person, there are some suggestions that are strongly recommended. While exfoliating salt rubs and massages can be done each week, for larger anti-aging treatments and body wraps, once every six weeks is a suitable time frame. For the more aggressive treatments such as chemical peels and microdermabrasion waiting 7 to 10 days between treatments is strongly encouraged, to allow the skin to fully heal and before more application, in order to prevent negative side effects such as burns. SIDE BAR 1: Do It Yourself Beauty Bar: At home skin care regiments are important, not only for daily care but to maintain the results of professional spa treatments. Here are some beneficial ways to improve your skin and put the spa experience into your own hands. * Mix used coffee grounds, cayenne pepper and an oil of any kind together to create a scrub, which use can be used on the thighs to help exfoliate and get rid of cellulite. Use once a week. * For breakouts, steam water on the stove and hold your face over the steam for five minutes to open the pores. Mix baking soda and water into a paste and spread it on the breakouts. Do once to twice a week. * Peel cotton pads into thin slices, dip into beaten egg whites and place on the face. When the egg whites and cotton dry, slowly peel the cotton off and rinse the face to clear the pores and tighten the skin. * Create an exfoliating wet facial rub by grinding oats and a small amount of water. * When it comes to exfoliating, it’s best to do so in the shower. The steam from the shower helps to penetrate the enzymes used in the products. For the body: exfoliate in the shower with the steam, fully rinse and shave afterward. For the face: because shaving is a form of exfoliation, alternate shaving and exfoliating routines. Shave in the morning and exfoliate in the evening or visa versa. SIDE BAR 2: Products for the At Home Spa Treatment: Amir Argan Oil Moisturizer Lotion: A daily moisturizer that revitalizes dull and dry skin and works to combat signs of aging and is composed of essential fatty acids, high levels of Vitamin E and Omega 6 and 9. Babor SkinovagePX Intensifier Moisture Plus and Illuminating Serum: Serums for long-lasting and intensive moisturizing and increased brightness and a fresher complexion. Pineapple Enzyme Scrub: A non-abrasive exfoliation, refining and nourishing treatment. A combination of Bromelain enzyme (obtained from pineapple), which removes excess surface cells and Jojoba beads, which dissolve and release nourishing oil into the skin. Use twice weekly prior to mask. Instant Oxygen Skin Revival Masque: An oxygenating treatment with aloe vera gel and a vitamin and ginseng complex to revive dull, tired skin by detoxifying, hydrating and replenishing it. 24 Karat Gold Anti-Aging Suspension: An age-defying combination of 24 karat gold, antioxidants, botanicals and oils to strengthen the skin’s elasticity and firmness. Why Vaccines are Important It is quite possible to contract diseases that are easily transferred to your unborn child in utero. Outbreaks like modern measles scares and coronavirus outbreaks make it increasingly important for pregnant moms to be to make sure they get the appropriate vaccines during pregnancy. All vaccine recommendations and made by the Center for Disease Control (CDC) are determined based on the vaccine composition, for example live vaccines should not be given to pregnancy; safety concerns for mother and baby; and risk factors for infection. However, they should be administered under a doctor’s prescription to ensure that they are taken at the right time and for the right reasons. Also, it is important to keep in mind that some vaccines, such as the influenza vaccine, contain eggs that may pose allergic risks to some women. Prior to receiving any vaccinations during pregnancy, it is important to know which vaccinations have already been received. This can be determined using former school immunization records, as well as shot records from any clinics, pharmacies, or healthcare providers where immunizations may have been received. For expecting mothers, who are planning on international travel, it is also important to check with a healthcare provider to determine which, if any, vaccinations may be needed for entrance into a specific destination country, and which are safe to receive during pregnancy. Vaccines Before Pregnancy MMR (Measles, Mumps, and Rubella) Vaccine: Not recommended during pregnancy. If not yet received; recommended at least one month prior to trying to become pregnant. (RED) When it comes to common vaccination requirements, in the United States, most individuals are vaccinated against measles, mumps, and rubella as children, known as the MMR vaccination. However, if these have not been received, it is recommended to do so prior to pregnancy, as these diseases, rubella in particular, can cause serious complications for the baby’s health. For women who have not received the MMR vaccination, it is recommended to receive this at least one month prior to trying to become pregnant. Chickenpox/Varicella Vaccine: Not recommended during pregnancy. If not yet received; recommended at least one month prior to trying to become pregnant. (RED) Additional common vaccination includes the chickenpox/Varicella vaccine, which, if contracted during pregnancy, can cause birth defects or pregnancy complications. For women who have not received the chickenpox/Varicella vaccine, it is recommended to receive this vaccine at least one month prior to trying to become pregnant. Additional common vaccines carry their own recommendations. Human Papillomavirus (HPV) Vaccine: Not recommended during pregnancy, but not a cause for concern if received before confirmed pregnancy. (RED) The HPV vaccine, though not specifically recommended during pregnancy poses no additional threats should it be administered while pregnant. Because this vaccine is typically given in two or three doses, additional doses may be postponed until after pregnancy if they were started during or prior to confirmed pregnancy. Typically, this vaccine is administered to individuals younger than 26, however receiving it before the age of 45 may be recommended if risk factors are present. Pneumococcal (Pneumonia) Vaccine: May be recommended during pregnancy if risk factors are present. (YELLOW) There are two types of Pnemococcal vaccines, one or both may be needed and this may only be suggested during pregnancy if certain risk factors are present. If not recommended during pregnancy, it is advised that this vaccine be administered prior to pregnancy or postpartum if mother needs it. Zoster (Shingles) Vaccine: Not recommended during pregnancy. Recommended after pregnancy if needed. (RED) The shingles vaccine is not advised to be given during pregnancy due to a lack of research to determine its impact on pregnancy and fetal health, however inadvertent vaccination has not shown any specific risks. Typical vaccination for this is received at the age of 50 or older in a two-dose series of vaccinations. Vaccines During Pregnancy Not all vaccines are required before pregnancy however, there are some specific ones that the CDC acknowledges women should be guided to obtain during pregnancy to help prevent transferring certain diseases to a growing fetus and keep expecting mothers safe. The following vaccines are those deemed as safe for expectant women who may be at risk of contracting infections. Influenza Shots: Deemed safe during pregnancy. Recommended during pregnancy. (GREEN) During pregnancy, a woman’s body gives most of its energy and attention to creating the baby, thus suppressing the immune system. Influenza shots are critical for protecting both the mother and her unborn child from the flu virus after exposure. One of the most commonly known yearly vaccines deemed safe at all stages of pregnancy, the flu vaccine should be administered in shot form, which is made from an inactivated virus, in preparation for flu season. The rarer flu nasal spray vaccine, LAIV, is not recommended for women who are pregnant, or who are trying to conceive as it contains a live strain of the virus. Although the flu may seem like an insignificant virus, it is important to know that contracting it during pregnancy may cause severe damage to a pregnant woman’s body. While healthy adults can carry the flu virus without showing any symptoms, expectant women tend to show a number of signs as the immune system tries to fight off the infection. Symptoms may include the following: •Respiratory complications •Premature labor •Severe nausea, Vomiting, or Diarrhea •Shortness of breath/Cough •Loss of appetite •Fatigue •Episodes of confusion •Fever or Sudden chills •Body aches •In severe cases, miscarriage Studies shows that women who get the flu during pregnancy find themselves sicker than they would be at any other time, and have an increased risk of premature labor, premature birth, premature birth weight, and miscarriage. Additionally, women who get the flu during pregnancy may be required to be hospitalized after birth and in some rare cases infection may be fatal. Additional precautions can include ensuring that all persons who are in close contact should also be vaccinated and women should avoid contact with those sick with the flu to reduce the risk of flu exposure. Tdap Vaccine (Whooping Cough): Deemed safe during pregnancy. Recommended during pregnancy. (GREEN) Offering protection against tetanus, diphtheria, and whooping cough (pertussis), the Tdap vaccine, can be administered safely at multiple stages depending on previous vaccination. The U.S. Centers for Disease Control and Prevention reports that on average, whooping cough accounts for about 1,000 infant hospitalizations and five to 15 infant deaths each year in the United Stated. For this reason, the whooping cough/Pertussis vaccine is the number one vaccine suggested for pregnant women. This vaccine offers protection to both the mother and unborn child, with optimal administration of the vaccine occurring around 27 weeks gestation to maximize the maternal antibody response and passive antibody transfer to the infant. Because the newborns and infants are at the highest risk of infection, Tdap vaccination is administered with the purpose of optimal protection to the baby during gestation and after birth. Because Tdap vaccination does not last as long as experts would like, preconception vaccination is not suggested as it may not provide optimal protection to the infant after birth. If Tdap vaccination is administered prior to conception, it is recommended that additional vaccination between weeks 27 and 36 occur. Hepatitis B and A: Deemed safe during pregnancy. Recommended if specific risk factors are present. (YELLOW) Hepatitis B is a vaccine-preventable severe liver infection that is spread through contact with infected blood and bodily fluids. The disease can easily be passed from mother to unborn child during delivery. Getting the hepatitis B vaccine during pregnancy can help protect the unborn baby from getting infected with the disease. If women have received prior hepatitis B vaccination, it can be beneficial to receive the vaccine again to prevent future infection of both mother and child. Additionally, those at a higher risk for contraction, such as those working as healthcare providers, should also consider getting this vaccination. For full immunity against hepatitis B, doctors may recommend a series of three doses. The first dose should be administered before pregnancy, the second at one month and the third at six months after the initial dose. Hepatitis A is a low-grade liver disease. This disease is not as serious as hep B, however it is something to consider taking precautions for. It is not likely the disease will be passed on to an unborn fetus, however, the possibility is there. Hepatitis A can cause infection in the newborn and premature labor. This is a vaccination that should be especially considered for women with chronic liver disease or residing with someone with the disease, or if they are traveling during their pregnancy, as hepatitis A is a disease that can be contracted through contaminated water and food. Coronavirus, COVID-19 Vaccine: Deemed safe during pregnancy. Recommended during pregnancy if not yet received. (GREEN) Research results on COVID-19 vaccines during pregnancy show that there is no negative risk of receiving the vaccine during pregnancy. Because of the highly contagious nature of COVID-19, it is important to provide the body with vaccination for preventative measures, even if full immunity is not possible. Like other immuno-compromised conditions, pregnancy presents an increased risk of severe complications and long-term symptoms due to infection with COVID-19. COVID-19 infection during pregnancy poses an increased risk of hospitalization, preterm birth, stillbirth and maternal fatality. Additionally, studies have found that pregnant women diagnosed with coronavirus had over a 60 percent chance of developing preeclampsia, even if the mother was asymptomatic (experienced no symptoms while infected with virus). While vaccination is highly recommended for all individuals, it is especially recommended for all women, even in those with a history of previous infection, who are pregnant, breastfeeding, or trying to get pregnant, as antibodies from the vaccine can be shared with the unborn baby, providing them with some immunity at birth. Can Immunizations Harm a Growing Fetus? Some vaccines are not recommended during pregnancy such as the MMR vaccine, HPV vaccine, and chickenpox (varicella) vaccine. As a general rule, vaccines with live viruses, such as the MMR and chickenpox vaccine, should not be given to pregnant women since they contain activated strains of the virus. Vaccines Do Not Cause Autism The loudest debate of vaccinations with pregnancy stems from an incomplete study conducted years ago, in which a gastroenterologist published a claim that the MMR vaccine caused autism in children. As a result of this claim, numerous private and government health agencies have attempted to recreate this study and achieved no results. The consensus in the medical community stating that there is no link between the MMR vaccination and the onset of autism. One vaccine ingredient that has been specifically criticized is thimerosal, a mercury-based preservative used to prevent germs from contaminating vials of vaccines. Since 2003, there have been nine CDC-funded or conducted studies exploring any link between thimerosal-containing vaccines and autism. These studies also found no link between the MMR vaccine and autism onset. Additionally, in 2004 a scientific review by the Institute of Medicine (IOM) concluded that “the evidence favors rejection of a causal relationship between thimerosal–containing vaccines and autism.” Scientific research determines that it is not only safe to immunize children with the MMR vaccine, but it is also advised to continue vaccination protocols as recommended by medical professionals. Final Considerations All in all, there are a number of vaccines that are recommended before, during, and after pregnancy for mom and baby. These vaccines are determined by various factors such as lifestyle, medical history, age and risk factors, and it is important to include necessary vaccination requirements into a vaccination plan when planning additional tests and procedures required at various stages of pregnancy and postpartum. After conception, a baby begins to develop their immune system from the mother’s immune system before birth. Proper vaccination during pregnancy can help their developing immune system progress throughout gestation until they are born, when the vaccines received during pregnancy can provide baby a safeguard once they are out of the womb. Vaccines are like any other medicine, which means they can have some side effects. However, most people who get vaccinated have no side effects or only mild short-term side effects. Like all aspects of pregnancy and health, no two pregnancies are the same, and women’s specific requirements and effects may play a role in determining which vaccinations are needed and not. Genetic factors, gene mutations and allergic reactions can all play a role in determining the risk factor and safety of certain vaccinations. Thus, it is important for expectant women to talk to their doctors to discuss any vaccination concerns they may have, and determine which vaccines should be taken during pregnancy and which ones should wait until postpartum or later.

Understanding Immunizations During Pregnancy

February, 2022

There’s no doubt, what happens to your body during pregnancy, happens to your baby. Due to the fact that there are many controversial opinions about vaccinations during pregnancy posted on the internet, many women remain uninformed of their importance while pregnant. This lack of proper information or misunderstanding of certain immunizations may, as a result, leave them vulnerable to contracting illnesses that could affect their health and their unborn children. Why Vaccines are Important It is quite possible to contract diseases that are easily transferred to your unborn child in utero. Outbreaks like modern measles scares and coronavirus outbreaks make it increasingly important for pregnant moms to be to make sure they get the appropriate vaccines during pregnancy. All vaccine recommendations and made by the Center for Disease Control (CDC) are determined based on the vaccine composition, for example live vaccines should not be given to pregnancy; safety concerns for mother and baby; and risk factors for infection. However, they should be administered under a doctor’s prescription to ensure that they are taken at the right time and for the right reasons. Also, it is important to keep in mind that some vaccines, such as the influenza vaccine, contain eggs that may pose allergic risks to some women. Prior to receiving any vaccinations during pregnancy, it is important to know which vaccinations have already been received. This can be determined using former school immunization records, as well as shot records from any clinics, pharmacies, or healthcare providers where immunizations may have been received. For expecting mothers, who are planning on international travel, it is also important to check with a healthcare provider to determine which, if any, vaccinations may be needed for entrance into a specific destination country, and which are safe to receive during pregnancy. Vaccines Before Pregnancy MMR (Measles, Mumps, and Rubella) Vaccine: Not recommended during pregnancy. If not yet received; recommended at least one month prior to trying to become pregnant. When it comes to common vaccination requirements, in the United States, most individuals are vaccinated against measles, mumps, and rubella as children, known as the MMR vaccination. However, if these have not been received, it is recommended to do so prior to pregnancy, as these diseases, rubella in particular, can cause serious complications for the baby’s health. For women who have not received the MMR vaccination, it is recommended to receive this at least one month prior to trying to become pregnant. Chickenpox/Varicella Vaccine: Not recommended during pregnancy. If not yet received; recommended at least one month prior to trying to become pregnant. Additional common vaccination includes the chickenpox/Varicella vaccine, which, if contracted during pregnancy, can cause birth defects or pregnancy complications. For women who have not received the chickenpox/Varicella vaccine, it is recommended to receive this vaccine at least one month prior to trying to become pregnant. Additional common vaccines carry their own recommendations. Human Papillomavirus (HPV) Vaccine: Not recommended during pregnancy, but not a cause for concern if received before confirmed pregnancy. The HPV vaccine, though not specifically recommended during pregnancy poses no additional threats should it be administered while pregnant. Because this vaccine is typically given in two or three doses, additional doses may be postponed until after pregnancy if they were started during or prior to confirmed pregnancy. Typically, this vaccine is administered to individuals younger than 26, however receiving it before the age of 45 may be recommended if risk factors are present. Pneumococcal (Pneumonia) Vaccine: May be recommended during pregnancy if risk factors are present. There are two types of Pnemococcal vaccines, one or both may be needed and this may only be suggested during pregnancy if certain risk factors are present. If not recommended during pregnancy, it is advised that this vaccine be administered prior to pregnancy or postpartum if mother needs it. Zoster (Shingles) Vaccine: Not recommended during pregnancy. Recommended after pregnancy if needed. The shingles vaccine is not advised to be given during pregnancy due to a lack of research to determine its impact on pregnancy and fetal health, however inadvertent vaccination has not shown any specific risks. Typical vaccination for this is received at the age of 50 or older in a two-dose series of vaccinations. Vaccines During Pregnancy Not all vaccines are required before pregnancy however, there are some specific ones that the CDC acknowledges women should be guided to obtain during pregnancy to help prevent transferring certain diseases to a growing fetus and keep expecting mothers safe. The following vaccines are those deemed as safe for expectant women who may be at risk of contracting infections. Influenza Shots: Deemed safe during pregnancy. Recommended during pregnancy. During pregnancy, a woman’s body gives most of its energy and attention to creating the baby, thus suppressing the immune system. Influenza shots are critical for protecting both the mother and her unborn child from the flu virus after exposure. One of the most commonly known yearly vaccines deemed safe at all stages of pregnancy, the flu vaccine should be administered in shot form, which is made from an inactivated virus, in preparation for flu season. The rarer flu nasal spray vaccine, LAIV, is not recommended for women who are pregnant, or who are trying to conceive as it contains a live strain of the virus. Although the flu may seem like an insignificant virus, it is important to know that contracting it during pregnancy may cause severe damage to a pregnant woman’s body. While healthy adults can carry the flu virus without showing any symptoms, expectant women tend to show a number of signs as the immune system tries to fight off the infection. Symptoms may include the following: •Respiratory complications •Premature labor •Severe nausea, Vomiting, or Diarrhea •Shortness of breath/Cough •Loss of appetite •Fatigue •Episodes of confusion •Fever or Sudden chills •Body aches •In severe cases, miscarriage Studies shows that women who get the flu during pregnancy find themselves sicker than they would be at any other time, and have an increased risk of premature labor, premature birth, premature birth weight, and miscarriage. Additionally, women who get the flu during pregnancy may be required to be hospitalized after birth and in some rare cases infection may be fatal. Additional precautions can include ensuring that all persons who are in close contact should also be vaccinated and women should avoid contact with those sick with the flu to reduce the risk of flu exposure. Tdap Vaccine (Whooping Cough): Deemed safe during pregnancy. Recommended during pregnancy. Offering protection against tetanus, diphtheria, and whooping cough (pertussis), the Tdap vaccine, can be administered safely at multiple stages depending on previous vaccination. The U.S. Centers for Disease Control and Prevention reports that on average, whooping cough accounts for about 1,000 infant hospitalizations and five to 15 infant deaths each year in the United Stated. For this reason, the whooping cough/Pertussis vaccine is the number one vaccine suggested for pregnant women. This vaccine offers protection to both the mother and unborn child, with optimal administration of the vaccine occurring around 27 weeks gestation to maximize the maternal antibody response and passive antibody transfer to the infant. Because the newborns and infants are at the highest risk of infection, Tdap vaccination is administered with the purpose of optimal protection to the baby during gestation and after birth. Because Tdap vaccination does not last as long as experts would like, preconception vaccination is not suggested as it may not provide optimal protection to the infant after birth. If Tdap vaccination is administered prior to conception, it is recommended that additional vaccination between weeks 27 and 36 occur. Hepatitis B and A: Deemed safe during pregnancy. Recommended if specific risk factors are present. Hepatitis B is a vaccine-preventable severe liver infection that is spread through contact with infected blood and bodily fluids. The disease can easily be passed from mother to unborn child during delivery. Getting the hepatitis B vaccine during pregnancy can help protect the unborn baby from getting infected with the disease. If women have received prior hepatitis B vaccination, it can be beneficial to receive the vaccine again to prevent future infection of both mother and child. Additionally, those at a higher risk for contraction, such as those working as healthcare providers, should also consider getting this vaccination. For full immunity against hepatitis B, doctors may recommend a series of three doses. The first dose should be administered before pregnancy, the second at one month and the third at six months after the initial dose. Hepatitis A is a low-grade liver disease. This disease is not as serious as hep B, however it is something to consider taking precautions for. It is not likely the disease will be passed on to an unborn fetus, however, the possibility is there. Hepatitis A can cause infection in the newborn and premature labor. This is a vaccination that should be especially considered for women with chronic liver disease or residing with someone with the disease, or if they are traveling during their pregnancy, as hepatitis A is a disease that can be contracted through contaminated water and food. Coronavirus, COVID-19 Vaccine: Deemed safe during pregnancy. Recommended during pregnancy if not yet received. Research results on COVID-19 vaccines during pregnancy show that there is no negative risk of receiving the vaccine during pregnancy. Because of the highly contagious nature of COVID-19, it is important to provide the body with vaccination for preventative measures, even if full immunity is not possible. Like other immuno-compromised conditions, pregnancy presents an increased risk of severe complications and long-term symptoms due to infection with COVID-19. COVID-19 infection during pregnancy poses an increased risk of hospitalization, preterm birth, stillbirth and maternal fatality. Additionally, studies have found that pregnant women diagnosed with coronavirus had over a 60 percent chance of developing preeclampsia, even if the mother was asymptomatic (experienced no symptoms while infected with virus). While vaccination is highly recommended for all individuals, it is especially recommended for all women, even in those with a history of previous infection, who are pregnant, breastfeeding, or trying to get pregnant, as antibodies from the vaccine can be shared with the unborn baby, providing them with some immunity at birth. Can Immunizations Harm a Growing Fetus? Some vaccines are not recommended during pregnancy such as the MMR vaccine, HPV vaccine, and chickenpox (varicella) vaccine. As a general rule, vaccines with live viruses, such as the MMR and chickenpox vaccine, should not be given to pregnant women since they contain activated strains of the virus. Vaccines Do Not Cause Autism The loudest debate of vaccinations with pregnancy stems from an incomplete study conducted years ago, in which a gastroenterologist published a claim that the MMR vaccine caused autism in children. As a result of this claim, numerous private and government health agencies have attempted to recreate this study and achieved no results. The consensus in the medical community stating that there is no link between the MMR vaccination and the onset of autism. One vaccine ingredient that has been specifically criticized is thimerosal, a mercury-based preservative used to prevent germs from contaminating vials of vaccines. Since 2003, there have been nine CDC-funded or conducted studies exploring any link between thimerosal-containing vaccines and autism. These studies also found no link between the MMR vaccine and autism onset. Additionally, in 2004 a scientific review by the Institute of Medicine (IOM) concluded that “the evidence favors rejection of a causal relationship between thimerosal–containing vaccines and autism.” Scientific research determines that it is not only safe to immunize children with the MMR vaccine, but it is also advised to continue vaccination protocols as recommended by medical professionals. Final Considerations All in all, there are a number of vaccines that are recommended before, during, and after pregnancy for mom and baby. These vaccines are determined by various factors such as lifestyle, medical history, age and risk factors, and it is important to include necessary vaccination requirements into a vaccination plan when planning additional tests and procedures required at various stages of pregnancy and postpartum. After conception, a baby begins to develop their immune system from the mother’s immune system before birth. Proper vaccination during pregnancy can help their developing immune system progress throughout gestation until they are born, when the vaccines received during pregnancy can provide baby a safeguard once they are out of the womb. Vaccines are like any other medicine, which means they can have some side effects. However, most people who get vaccinated have no side effects or only mild short-term side effects. Like all aspects of pregnancy and health, no two pregnancies are the same, and women’s specific requirements and effects may play a role in determining which vaccinations are needed and not. Genetic factors, gene mutations and allergic reactions can all play a role in determining the risk factor and safety of certain vaccinations. Thus, it is important for expectant women to talk to their doctors to discuss any vaccination concerns they may have, and determine which vaccines should be taken during pregnancy and which ones should wait until postpartum or later.

A Complete Guide to Nuchal Translucency Scan

November, 2022

An alternative ultrasound conducted during the first trimester of pregnancy, a nuchal translucency screening is one of the most accurate screening tests available today for early prenatal diagnosing. These scans can aid in determining your baby’s risk of congenital disorders such as Down syndrome and can reduce the risk of your child being born with a chromosome abnormality, as they are rather accurate at spotting concerns when paired with other first-trimester examinations. Understanding Down Syndrome, Trisomy 13, and Trisomy 18 Down syndrome (trisomy 21), Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13), are genetic abnormalities that cause developmental disorders and congenital malformations. While most babies are born with 23 chromosomes from each parent, paired together for a total of 46 chromosomes. Babies with Down syndrome however, end up with three chromosomes at position 21, instead of the usual duo pair. Likewise, other trisomies can occur at chromosomal position 13 and 18. Babies with Down syndrome (trisomy 21), are the most common congenital chromosomal disorder, causing lifelong intellectual delays, impaired social development and physical issues, including those involving the heart, digestive system and other organ systems. Edwards syndrome (trisomy 18) is less common than Down syndrome, affecting approximately 1 in 3315 births. It can cause serious physical problems such as heart defects, kidney problems and irregularities to the head or face. Typically, babies born with this disorder may not survive beyond their first week, with only about 10 percent reaching age one. Patau syndrome (trisomy 13) is the most severe chromosomal abnormality, causing serious and usually life-threatening health problems such as profound mental disability, heart, brain or spinal cord defects, extra fingers or toes or a number of other abnormalities. Only about 10 percent of babies born with Patau syndrome survive past age one. The Purpose of Nuchal Translucency Scan It has been found that the likelihood of having a child born with chromosomal abnormalities increases with increased maternal age. However, that being said, anyone can have a child with chromosomal abnormalities regardless of age. Therefore, screening is available to pregnant women. A nuchal translucency scan uses an ultrasound of the abdomen to measure the level of fluid-filled space behind your baby’s neck, also known as nuchal translucency. The measurement of these levels do not serve as a diagnostic but too much or too little fluid can help your doctor estimate the risk of your baby having a chromosomal abnormality. This scan is typically performed between 11 and 14 weeks of pregnancy, however for women referred for a dating scan, which typically take place before week 12 of pregnancy, a nuchal translucency scan can take place at the same time. The reason for this time frame is due to the fact that the fluid behind the neck that is tested tends to be reabsorbed by the body after 14 weeks of gestation, thus making it harder to measure later in pregnancy. Additionally, a maternal blood sample is taken for cross reference with testing and paired with specific blood tests that measure pregnancy related substances of PAPP-A (pregnancy-associated plasma protein-A) and HCG (human chorionic gonadotropin). Effectiveness of First-Trimester Combined Screening Since this is a screening test, a positive outcome (showing a higher risk) does not necessarily indicate that your unborn child has a developmental problem, rather, it suggests that additional diagnostic tests are possibilities for consideration. Likewise, a negative or normal outcome (one which indicates a reduced risk) does not necessarily mean that the unborn child will not have a chromosomal abnormality. Despite this uncertainty, first-trimester scanning has a detection rate of around 98 percent for pregnancy complications in which the unborn has Down syndrome and a slightly higher rate for pregnancies in which trisomy 13 or trisomy 18 are present. Even though a nuchal translucency scan can be done without bloodwork, without a maternal blood panel to cross reference, the success rate drops to around 70 percent. Chromosomal abnormality probability is based on three criteria: maternal age, information obtained from the nuchal translucency ultrasound and early pregnancy bloodwork. The combination of these results can alert your doctor if there is an increased risk for one of these chromosomal disorders or on the other hand, provide reassurance that your baby is at a lower risk. While scans might reassure you that your baby is growing correctly, they may also reveal that your child has an increased chance of developing a chromosomal abnormality. Thus, it is advisable to have a doctor and medical team you trust to help guide you through additional testing should the test reveal a high risk of chromosomal abnormality in your unborn child. If there is any indication of an increased risk, further testing, such as chorionic villus sampling (CVS) or amniocentesis, both of which are more accurate than a nuchal translucency scan, may be recommended by your health care practitioner. Preparing for the Test The most acceptable ultrasound image may be achieved with a full bladder. Two or three glasses of water are recommended to be consumed an hour before taking any examination. If you have a nuchal translucency scan scheduled, it is advised to avoid urinating immediately prior to the ultrasound test. When it comes to sensations, rest assured knowing that ultrasound waves are too weak to be felt. The only sensations commonly felt are a mild chill and moist feeling from the ultrasound gel used in the exam, and as a result of the added pressure the ultrasound test can place, slight discomfort may be experienced for some women. What is Normal Nuchal Translucency Measurement? For most pregnancies, a nuchal translucency scan of less than 3.5 millimeters is deemed acceptable. Until your baby is 14 weeks old, their nuchal translucency scan measurement usually increases as they grow. After this point, as mentioned before, the excess fluid is typically reabsorbed. So, even if a developing fetus does have a chromosomal condition, a later nuchal translucency scan may give a normal measurement. This is why it’s essential to do more tests or screenings for cross referencing results and present risk factors. Should I get a Second-Trimester Screening? The second-trimester maternal serum screening test, often known as the quad screen, is administered between 16 to 20 weeks of gestation and measures substances in the mother’s blood. Similar to the first-trimester screening, second-trimester quad-screening results can be utilized to statistically adjust risk for Down syndrome and trisomy 18, however not trisomy 13. In addition, the Alpha-fetoprotein (AFP), a plasma protein produced by the embryonic yolk sac and the fetal liver, test, done between weeks 15 and 20 can identify pregnancies with a greater risk of other developmental issues such as open neural tube abnormalities like spina bifida. It should be noted that some doctors do not advise quad screening be done if combined first-trimester testing has been completed. However, AFP can be obtained as a screening test for spina bifida on its alone. While the list of potential risks and subsequent testing may seem overwhelming during pregnancy, together with a competent doctor, women should be able to decide whether prenatal diagnosis is something to consider and which screening or testing method is most appropriate.

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Severe Hot Flashes, Night Sweats During Menopause Linked to Dementia, Stroke Risk

November, 2022

For middle aged women, night sweats and hot flashes can be more than an inconvenient side effect of menopause, in fact they could be a sign of more extensive health complications down the road. A recent study found correlations between night sweats and severe hot flashes, and the potential for strokes and dementia. The study, published in August 2022, found a connection between frequent night sweats and hot flashes, and white matter hyperintensities (WMIs); that is, tiny brain lesions. These WMIs, in turn, have been linked to a greater occurrence of cognitive decline and stroke. That’s not the only concern however, other studies have connected severe night sweats and hot flashes with greater likelihood of heart disease onset and cardiac concerns, such as stroke. While the studies take a natural progression of aging into account, it should be noted that within these early studies, participants were mostly limited to small samples and were made up of primarily white women. Still, even with the limited study sampling, the results appear to show some noteworthy results. WMIs During Menopause Typically occurring between ages 45 and 55, menopausal hot flashes affect approximately 70 to 75 percent of women during menopause. A study as early as 2016 pointed to a link between WMIs and hot flashes, raising the possibility of greater risk to the heart and brain with the presence of more frequent or severe hot flashes. Researchers advised caution and lifestyle changes, but said more study was needed to clarify the direct link. More recent studies however, have come closer to pinpointing the connection. In the study published in “Neurology,” 226 women ages 45 to 67 who were not undergoing hormone therapy were monitored for vasomotor symptoms (VMS), meaning night sweats and hot flashes. Those with greater VMS were found to have a greater volume of white matter hyperintensity, and thus greater potential for brain decline and stroke. Another study, of 3,300 women from across the United States, found that women with more frequent or intense night sweats were more likely to have classic symptoms considered risks for heart disease: high blood pressure, high cholesterol, diabetes and fat buildup in the arteries. An additional 2016 study, conducted by the University of Pittsburgh and published in “Stroke,” involved 304 women and concluded that participants with greater VMS were more likely to have narrowed blood vessels that carry blood from the heart to the brain, ultimately pointing to a greater risk of stroke. Risks After Menopause When it comes to these health concerns, cardiovascular disease is the main cause of death for women, and that risk has been found to increase substantially after menopause. Likewise, research have found that women are more prone to have dementia than men, with studies showing between 65 and 70 percent of dementia patients being female. Although many factors can contribute to these statistics, the research done on increased risks and the impact of WMI on such health concerns creates a connection that can be helpful in women’s preventive health. Should I Be Worried? If you’re currently bothered by consistent night sweats or hot flashes, the best course is to consult your doctor both for immediate solutions to ease your symptoms, and for recommendations on lifestyle changes that can help not only your symptoms, but your overall health as you age. While these studies indicate there may be a link between the symptoms and brain and heart health, doctors say these steps can help improve your health and decrease your risk factors: Improve your diet, since fat and sugar can contribute to a range of health problems, look at limiting or avoiding added and artificial sugars as well as trans fats. Participate in at least 150 minutes of exercise on a weekly basis. Regular aerobic (such as jogging, hiking or swimming) and anaerobic (such as weight lifting, squats, and plyometrics) exercise can improve your health and promote better heart health. Have your doctor check your cholesterol, blood sugar and blood pressure, as well as your body mass index to monitor any lulls or spikes that are cause for concern and ensure they are addressed early to prevent future health problems. Since hormonal changes are a big factor in menopause, it’s helpful to consult a gynecologist or endocrinologist to see whether hormone treatment is an option that would help in your situation. While menopause is a normal part of aging, it needn’t be the start of decline. Instead, healthier habits and attention to brain and heart health can help you stay fit for years to come and avoid increased risk factors for disease.

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How Blocked Fallopian Tubes Affect Fertility

October, 2022

When it comes to fertility, fallopian tube health is crucial, and a blocked fallopian tube, or tubes, can be a serious cause for concern. While it may seem scary, the good news is that blocked fallopian tubes are not a hopeless condition, as there are a number of ways to unblock them and hence improve and restore fertility health. While many women find themselves in the unfortunate situation of being unable to conceive after years of trying, having blocked fallopian tubes is often one of the main causes for this. In fact, it is estimated that approximately one in four women with infertility have a tubal blockage of some sort. These two narrow tubes that connect the ovaries to the uterus are necessary for allowing eggs to travel from one ovary to the uterus, and serve as the meeting grounds for egg and sperm during conception. Thus, having unobstructed tubes is not only necessary but their crucial role is easily apparent. Causes of Blocked Fallopian Tubes With how common blocked fallopian tubes are, it’s no surprise that there are several causes, among them, are the following: 1. Pelvic Inflammatory Disease Pelvic inflammatory disease is a common infection that arises when certain sexually transmitted infections, such as gonorrhea or chlamydia, are left untreated for a long time. The infection causes inflammation of the fallopian tubes, which can then lead to blockage. 2. Endometriosis Endometriosis is a condition where tissue that normally lines the uterus grows, not only outside of it but in some cases can grow in the fallopian tubes and lead to blockage. 3. Fibroids and Cysts Fibroids and cysts are non-cancerous growths that grow on the walls of the uterus. While many of these are commonly on the uterus and ovaries, in some cases these growths grow in the fallopian tubes and can lead to blockage. 4. Scarring from Previous Surgeries In some severe cases, previous surgeries can result in scarring if surgeons or procedures resulted in cutting into the fallopian tube. This scarring and buildup of scar tissue can ultimately lead to blockage. 5. Chronic Infection in the Urinary Tract or Bladder A urinary tract infection, or UTI, can do more than a common bladder issue, when left untreated, these infections can lead to scarring and inflammation of the fallopian tubes, which can ultimately lead to a blockage. 6. Tubal Ligation Women with tubes tied are also prone to block fallopian tubes. This is because tubal ligation weakens the muscles that normally contract and relax. Reversal of tied tubes to allow for fertility can be done, but fallopian tube health and clearing should be checked once completed. 7. Ectopic Pregnancy An ectopic pregnancy is a condition that arises when the egg implants within the fallopian tube instead of within the uterus. Given that fallopian tubes are narrow, this can lead to blockages and severe risk for baby and mother that should be treated immediately. 8. Endometrial Hyperplasia Endometrial hyperplasia refers to abnormal growth of the endometrium, which is the lining of the uterus, and the fallopian tubes. Ultimately, this condition is typically caused by excessive estrogen production. 9. Hydrosalpinx Blockage A hydrosalpinx blockage is a result of infection within the fallopian tube, typically due to a sexually transmitted infection and occurs when fluid fills and enlarges a fallopian tube leading to blockage. Additionally, there are additional fallopian tube abnormalities that may lead to blockages or increase the chance of a blockage and compromised fertility. Symptoms of a Blocked Fallopian Tube While it may be nice to consider some key symptoms to be on the lookout for, the worst thing about having a blocked fallopian tube is that in many cases, women may not know there is a blockage until they try to get pregnant. This being said, it is important to keep track of any changes in periods or menstrual cycle as well as conception difficulties and to let a doctor know if anything abnormal is noticed or there is a difficulty getting pregnant. In certain cases, a person suffering from the hydrosalpinx blockage may experience regular pain on the affected side of the abdomen. As such, it is important to pay close attention to any pain that is experienced in the abdomen for prolonged periods of time. Additionally, it is important to note that there are symptoms that can also arise due to the underlying conditions that cause a blockage in the first place. If a blockage is caused by endometriosis, for example, additional symptoms may be experienced such as painful and heavy periods and pelvic pain. As previously mentioned, having one or both fallopian tubes blocked can make it near impossible to get pregnant naturally. However, with adequate treatment, things can be cleared up and fertility restored. Treating for a Blocked Fallopian Tube 1. Taking Medication to Treat Endometriosis In the case of endometriosis, there are a number of drugs that can be taken to relieve the pain and discomfort, and in some cases, saline infusions may also be used. However, it is important to note that in some cases, advanced treatment may be required in order to alleviate issues surrounding endometriosis completely. 2. Hysterosalpingogram, HSG A doctor may order for a hysterosalpingography test if there has been trouble getting pregnant, or there have been problems with pregnancy such as multiple miscarriages. While the primary purpose of a HSG is to help diagnose the causes of infertility, this type of test flushes dye through the uterus and fallopian tubes while X-rays are taken to identify any issues. Because this test moves fluid through the tubes it is possible that it can clear minor blockages that are present. 3. Tubal Cannulation This is an advanced non-surgical treatment that may be done immediately after having a hysterosalpingography procedure and involves the use of a catheter and is primarily used for blockages that are close to the uterus. With this procedure, a doctor will guide the catheter to the affected area with the help of X-rays or ultrasounds. Once reached, a small balloon will be inflated to help remove the blockage. 4. Tubal Surgery Tubal surgery is often a last resort when other therapies have failed to unblock a fallopian tube. In this procedure, a doctor performs an incision in the abdomen to reach the affected fallopian tube and then removes the blockage manually. The incision is then stitched up, as is the damaged tube and other parts of the tubes and alternate tube will remain intact for a successful future conception. While medical intervention or surgical procedures are the most common approach to treating a blocked fallopian tube, there are natural remedies that can be done as well to aid in the process. These primarily include dietary changes and herbal remedies. Having blocked fallopian tubes can be a major cause of worry and concern. However, it is important to gather all the information needed about the condition and approach it with a positive attitude. With advanced treatment options and proper care and precaution, you can get your fertility back in shape and be on the road to conceiving and having a healthy baby.

What Pregnant Women Should Know About COVID Variants

May, 2022

Being pregnant during the COVID-19 pandemic has been a concern to many women, especially those who are pregnant. While the height of the initial pandemic wave is over, with variants and subvariants continuing to emerge and case numbers fluctuating, the threat of the virus is still looming, even for those individuals who have already contracted the virus. Even with vaccines now in play, coronavirus infection risk is still present. Thus, it is important to take precautions to ensure that both mother and unborn baby are remaining safe with no unnecessary complications. There’s no doubt that women undergo many changes during pregnancy. From first trimester to the third, pregnancy can put additional strain on the health of a woman’s kidneys, heart and entire immune system. This means that contracting any of the COVID variants during pregnancy can put a major risk on the health of a woman and that of her unborn baby. The Risk of COVID-19 During Pregnancy While many women may understand their immune system is weaker during pregnancy, what many don’t realize is that this is the body’s intentional response to allow the fetus to develop without being rejected by the body. Although this is helpful to the growing baby, it can make women more vulnerable to various illnesses and infections such as urinary truck infections, flu, colds, and the coronavirus, COVID-19 and its multiple variants. Although studies have shown that both pregnant and non-pregnant women have the same chances of contracting COVID-19, pregnant women are more susceptible to more severe cases, complications and additional risks compared to those who are not pregnant. Some of the increased risks associated with COVID-19 infection during pregnancy include: Placenta previa Preterm labor Preeclampsia Blood clots Gestational diabetes Respiratory complications Stillbirths One of the confusing aspects of the COVID-19 virus and its variants is the scale of which it can affect individuals infected. While some individuals who contract COVID-19 experience mild symptoms, others can experience severe complications or worse, and as variants continue to emerge, a lot of research is still continuing with regard to the correlation between pregnancy and COVID variants, but many results are showing that some variants, such as Delta and Omicron may be just as contagious and severe, if not more so, than the initial virus. COVID-19 Effect on Newborns One of the biggest concerns amongst women in their third trimester is whether their baby will be born with COVID if they are sick, and while studies have shown that most newborns from women who had contracted COVID-19 while pregnant don’t turn out to be positive when they are born. However, as a result of their smaller airways and undeveloped immune systems, that make them even more vulnerable to respiratory infections and breathing difficulties, infants have a higher risk of experiencing severe illness due to infections compared to older children. Because of this, studies have shown that there are some newborns who have tested positive shortly after birth; possibly due to prolonged contact made with mother or anyone close to them who has the virus in their system, whether symptomatic or asymptomatic. While babies and children tend to have milder COVID-19 symptoms than adults, symptoms may still include; Cough Fever and chills Shortness of breath (more common in adults) Muscle and body aches Sore throat Pneumonia Loss of taste and/or smell Headache Diarrhea Fatigue Nausea or vomiting Additionally, in one study, research found that babies born during the pandemic’s first year scored slightly lower on developmental screening tests at six months compared with babies born just before the pandemic. While the virus may not be at a high transmissible rate to the baby at the time of childbirth, research has shown that protective antibodies are found in infants who are born to vaccinated mothers, compared to mothers who were unvaccinated or who were previously infected. A Look at COVID Variants and Their Impact on Pregnancy Delta Variant: Delta variant turned out to be one of the most dangerous and infectious COVID variants. Those who got infected with the variant experienced severe symptoms and complications. Researchers also discovered that even people who had already been vaccinated were at risk for infection and reinfection with the Delta variant. With regards to pregnant women, studies have found that most pregnant women who get infected with the virus have increased risks of developing more complicated cases of COVID-19 compared to their counterparts who are not pregnant. Omicron Variant: The Omicron variant was first detected in South Africa and Botswana. Doctors say that the variant is highly infectious; spreading more quickly and easily compared to other COVID-19 variants. Considering the fact that pregnancy lowers immunity, women are encouraged to do everything possible to avoid contracting the virus. In fact, studies have shown that during the Omicron surge pregnant women were diagnosed with COVID-19 at higher rates than during previous phases of the pandemic. While the rate of infection was higher than previous variants, the risks associated to them were less. In fact, the Omicron variant appears to cause more mild symptoms than the previous Delta variant. BA.2 Variant and Other Omicron Subvariants: The Omicron Sub-variant BA.2 has been described as the most dominant strain of COVID-19 in the world. This variant, along with the additional subvariants of Omicron, B.1.1.529, BA.1, BA.1.1, BA.3, BA. 4 and BA. 5 have all been classified as highly infectious and spread more easily than other variants. Like the initial Omicron variant, data suggests that the subvariants of Omicron pose risk to pregnant women but may be less severe in general. Even with vaccination, breakthrough infections are possible although being up to date on recommended vaccines, which have been deemed safe during pregnancy, can be effective at preventing severe complications, hospitalizations and death. What to Know About COVID Variants While there is no clear data that supports the fact that pregnant women have a higher risk of COVID-19 complications, evidence suggests that people whose immune systems have been compromised (such as the elderly and pregnant women) are more vulnerable to COVID-19 complications compared to healthy individuals. Avoiding Coronavirus During Pregnancy As mentioned earlier, the immune system of women during pregnancy is significantly lowered. This means that they are generally vulnerable to various infections including COVID-19 and its variants, thus it is important to try as much as possible to avoid contracting coronavirus. Taking precautions and adhering to recommendations from the Center for Disease Control (CDC) including: Avoiding contact with people who have COVID-19 Maintaining social distance of at least six feet when recommended Wearing masks in public places Practicing proper hygiene with regular hand washing Get recommended vaccines during pregnancy Call your healthcare professional if you have any concerns about your pregnancy, or if you think that you may have COVID-19. It is important to also know that should you contract COVID-19 or any of its variants during your pregnancy, be sure to contact your OB-GYN or primary care provider for any additional monitoring throughout the pregnancy period. For women closer to their due date, doctors may even recommend inducing the baby close to delivery date to provide mothers more energy to recover from the virus.

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