Your brain sees the world upside down. When the rods and cones of your retina send an image to the brain-say you're looking at a tree-the image that gets transmitted to the brain is upside down.
The brain automatically rotates the image in its visual cortex. Babies learn to do this early on. It's so automatic, you do not know you're doing it.
Wishing all of the dads a great Father's Day with a tribute to the history of how Father's Day came to fruition.
Also in this issue of our newsletter, we are excited to announce our new mobile friendly website! Please take a look and let us know your thoughts. In addition, we share the latest medical findings discussed at the annual ACOG meeting. In our Healthy Living section, we review heat exhaustion and how to take precautions, especially in very humid temperatures. And, you'll find a new interesting "Medical Fact".
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Please take a minute to browse the site and become familiar with the available resources so you can utilize them often. We welcome your comments!
The Latest Clinical And Scientific News From ACOG
By Dr. Meryl Kahan
Every year, the ACOG, American Congress of Obstetricians and Gynecologists - the go-to resource for the specialty, holds a clinical and scientific meeting. At this meeting, thousands of ob/gyns from across the country and around the world come together to learn about new research and updates on clinical practice, with the goal of improving patient care. This year's meeting was no exception. Experts in the field provided new practical information on topics ranging from preterm birth to perinatal depression to menopause and sexual health.
Dr. Huang and I attended this important meeting this year. A large focus of the conference was placed on preterm birth, since it has such public health implications, and will be the main focus of this article.
Preterm birth, defined as birth prior to 37 weeks gestation, is relatively common in that it affects over 11% of all deliveries. However, this rate has been steadily decreasing over the last several years thanks to the introduction of progesterone as a preventive strategy for women who have had a prior preterm delivery. It is standard of care for these women to receive weekly progesterone injections, from 16-36 weeks gestation. The question remains, what additional management can be instituted to further decrease the risk of preterm birth in all patients, whether or not they had a prior preterm birth.
Much emphasis has been placed on cervical length, measured with a transvaginal ultrasound. However, cervical length is not always a routine part of the 20 week anatomy ultrasound, and many providers treat a shortened cervix by placing a stitch, called a cerclage, to help keep it closed with the goal of prolonging pregnancy.
Many recent studies have looked at whether it would be reasonable to implement universal cervical length screening between 18 and 24 weeks for all women, in an effort to identify patients with a short cervix who may be at higher risk of going into preterm labor. If shortened, current protocols recommend daily use of vaginal progesterone rather than placement of a cerclage, since progesterone has already been shown to decrease preterm birth in those at risk. This is not to say that there is no longer a role for cerclage placement. For those patients who are already on progesterone injections for their history of preterm birth, they should be getting continuous cervical length measurements from 16-24 weeks. If the cervix is shortened, they should be offered a cerclage rather than vaginal progesterone, since they are already on some form of progesterone.
Multiple gestations account for about 20% of all preterm births, and unfortunately nothing, neither progesterone nor cerclage, has proven beneficial in preventing preterm birth in these cases.
Other interesting topics covered at the conference included:
Non-invasive prenatal testing
We routinely offer screening tests to our pregnant patients to detect certain anomalies such as trisomies 13, 18, 21, and open neural tube defects using a combination of bloodwork and an ultrasound.
Newer blood tests detect trisomies 13, 18, and 21 to a greater degree by measuring portions of fetal DNA circulating in the mother's blood. These tests are primarily reserved for patients considered to be higher risk for having fetuses with these abnormalities (including 35 or older at time of delivery).
Many "low risk" patients request this newer testing, yet it may not be the best option. Fetal abnormalities in younger patients are much more likely to be due to other causes undetectable by these tests.
A positive (abnormal) test result in lower risk patients is more likely to be a false positive than in higher risk patients.
These are all screening tests, not diagnostic tests, so any positive result should be followed by definitive testing.
All patients are screened postpartum but perhaps should also be screened earlier in pregnancy.
SSRIs, a popular type of anti-depressant, are safe to take during pregnancy if needed.
Untreated depression can have negative impacts on pregnancy, including impaired fetal growth and adverse maternal behavior.
Sexual desire in menopause
There are different causes of sexual dysfunction, including discomfort and decreased desire.
Having intercourse up to two times per week will maintain the "youthfulness" of the vagina and vulva.
If lubricants and moisturizers do not work, there are many forms of vaginal/local estrogens ranging from creams to tablets to rings that only minimally raise the body's overall estrogen level and are safe to use.
Low sexual desire can be exacerbated by certain medications including oral estrogen replacement which actually can decrease testosterone levels:
Transdermal estrogen replacements are considered the better option.
There are no FDA approved testosterone replacements for women at this time.
There are new products becoming available to increase sexual arousal in women:
Fiera by Nuelle will be available this summer as a small hands-free accessory that increases blood flow to vaginal area to increase arousal and desire.
As always, any questions can be directed towards any of our doctors. We look forward to continuing to provide you with the best and most up to date care possible.
The HIStory Of Father's Day
Following is an excerpt from History.
On July 19, 1910, the governor of the U.S. state of Washington proclaimed the nation's first "Father's Day." However, it was not until 1972, 58 years after President Woodrow Wilson made Mother's Day official, that the day became a nationwide holiday in the United States.
During the 1920s and 1930s, a movement arose to scrap Mother's Day and Father's Day altogether in favor of a single holiday, Parents' Day. Every year on Mother's Day, pro-Parents' Day groups rallied inNew YorkCity's Central Park-a public reminder, said Parents' Day activist and radio performer Robert Spere, "that both parents should be loved and respected together."
Paradoxically, however, the Depression derailed this effort to combine and de-commercialize the holidays. Struggling retailers and advertisers redoubled their efforts to make Father's Day a "second Christmas" for men, promoting goods such as neckties, hats, socks, pipes and tobacco, golf clubs and other sporting goods, and greeting cards. WhenWorld War IIbegan, advertisers began to argue that celebrating Father's Day was a way to honor American troops and support the war effort. By the end of the war, Father's Day may not have been a federal holiday, but it was a national institution.
In 1972, in the middle of a hard-fought presidential re-election campaign, Richard Nixon signed a proclamation making Father's Day a federal holiday at last.
Healthy Living: Heat Exhaustion
When seasons change, our bodies need time to acclimate to the fluctuation in temperatures, especially when it's 40 degrees one day and 85 the next.
A high heat index, coupled with strenuous physical activity, can be the perfect combination for a heat exhaustion episode. Humidity levels of 60% or more hampers sweat evaporation, which leads to your body overheating and being unable to cool itself. Heat exhaustion can occur from water or salt depletion and can includes symptoms such as:
rapid heart beat
loss of consciousness
goose bumps in the heat
When heat exhaustion goes awry and is not treated, it can lead to heat stroke - which can be serious as it can damage the brain and other vital organs, possibly even lead to death.
How do I relieve heat exhaustion?
It is essential to get out of the heat immediately and try to cool off your body and rest. Drink plenty of fluids, remove any tight or restrictive clothing, take a cool shower or bath and apply cool towels and/or air.
How do I avoid heat exhaustion?
One of the most important things you can do is listen to your body. If you feel yourself getting overheated, stop all activity and try to get to a cool place. You should also try to wear loose fitting clothing, stay out of direct sun, avoid caffeine and alcohol, drink lots of fluids and let your body acclimate to the heat.
Heat exhaustion is not something to be taken lightly - for you or your children.
The Rubino OB/GYN Group On LinkedIn
We are happy to announce we have created a company LinkedIn page for The Rubino OB/GYN Group where we will share information on the practice, new offerings, special announcements and much more.
The Rubino OB/GYN Group offers vitaMedMD™ in all 4 office locations. VitaMedMD offers patients high quality physician recommended products at an affordable price. Available products include Prenatal One, Menopause Relief and Iron 150.
Emmi Video Tutorials Emmi is a free, online video tutorial that makes complex medical information simple and easy to understand. Emmi provides clear and concise step-by-step information on common health topics and procedures right on our website. Click here to find out more.
Save Time with Online Appointments &Personal Health Records
To schedule online appointments or view your personal health records at your convenience, just visit the home page of www.rubinoobgyn.com. You can also call 973-736-1100 now to schedule an appointment at any of our four locations.
"Important Announcements" on Our Website
You can find important new developments and time-sensitive announcements (such as office closings) right on the upper right hand portion of our home page.
If you would like to add your business or service to the website,