Stage fright: don't get over it, get used to it

Many can feel empathy with the situation Banerjee describes: facing “a room full of scientists, who for whatever reason, did not look very happy that Read more

Beyond birthmarks and beta blockers, to cancer prevention

Ahead of this week’s Morningside Center conference on repurposing drugs, we wanted to highlight a recent paper in NPJ Precision Oncology by dermatologist Jack Arbiser. It may represent a new chapter in the story of the beta-blocker propranolol. Several years ago, doctors in France accidentally discovered that propranolol is effective against hemangiomas: bright red birthmarks made of extra blood vessels, which appear in infancy. Hemangiomas often don’t need treatment and regress naturally, but some can lead Read more

Drying up the HIV reservoir

Wnt is one of those funky developmental signaling pathways that gets re-used over and over again, whether it’s in the early embryo, the brain or the Read more

obstetrics

Emory University Hospital Midtown rings in New Year with new babies

Elijah Jacobs Westbrook and mom, LaSonta Westbrook

Twins Sidney and Taylor Mency and mom Jazmin Mency

Emory University Hospital Midtown (EUHM) rang in 2011 with some new bundles of joy. The hospital’s first baby of the New Year was born at 1:35 am. Little Elijah Jacobs Westbrook made his surprise appearance about six weeks early, says his mother, LaSonta Westbrook. The 4 lb., 6 oz. little boy was quickly greeted by his three big sisters, who enjoyed seeing him through the nursery window. As the first boy in the family, Westbrook says Elijah can expect lots of “mothering” from his sisters.

A little more than an hour later, EUHM welcomed its first set of twins in 2011. At 2:49 a.m. and 2:58 a.m., twin girls Sidney and Taylor Mency were born. Also a little early, mom Jazmin Mency says the gift of her girls is a wonderful way to begin the New Year.

The hospital ended up delivering 14 babies on January 1, 2011 (including the three mentioned), a busy way to kick off the New Year.

Emory University Hospital Midtown features a comprehensive maternity center that combines all maternity services on one floor, including labor and delivery, mother-baby suites and general and special care nurseries. Its design reflects the hospital’s unique philosophy of developmentally supportive care, encouraging family involvement and ensuring optimal infant development.

EUHM opened the first neonatal intensive care unit (NICU) in the Southeast in 1981, and currently, it serves as the Emory Regional Perinatal Center, one of five centers in the South designated to care for high-risk infants. With a Level III-designated NICU, the hospital’s skilled neonatal nursery staff has the expertise and technology to care for and treat almost any medical or surgical complication in sick and premature infants.

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Stress increases health risks to mother and fetus

At Emory’s fifth annual predictive health symposium “Human Health: Molecules to Mankind,” Emory GYN/OB Sarah L. Berga, MD, discussed the state of childbirth in the United States and how maternal stress affects pregnant women and their fetuses.

Berga is McCord professor and chair of the Department of Gynecology and Obstetrics at Emory School of Medicine. Sadly, Berga has seen maternal mortality rise steadily since the 1980s when she entered her medical residency. Georgia, she says, has the worse maternal mortality in the country. And the United States fares worse than many countries when it comes to maternal mortality.

Despite the unfortunate rise in maternal mortality of late, the good news is physicians have now started to pay more attention to the effect of stress—both the physical and emotional kind—on women and their fetuses. Recent research shows stress has the same negative effect on the body as do organic diseases, such as thyroid disease. In fact, too much stress reduces thyroxine levels by about 50 percent, says Berga. But because there’s no clinical recognition of this, tests are needed to determine if thyroxine levels are indeed insufficient.

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Families reunite at Emory for annual “preemie” party

They are the hospital’s tiniest patients, and many must overcome the odds of prematurity and severe illness to survive. These premature babies, often called “preemies,” are cared for by the physicians and staff in the Special Care Nurseries at Emory University Hospital Midtown (EUHM).

The state-of-the-art nursery, designated a Level III nursery, provides the widest variety of advanced care available for premature and sick newborns. The neonatologists and nursery staff are all highly skilled in caring for these little babies and their many needs after birth. They also must teach the parents to care for their little ones when they go home.

Baby in the NICU

Baby in the NICU

Some of the infants are there for just a week or two. Others are there for months. And during their stay, special bonds are formed and many precious milestones are shared between the families and their caretakers.

Each December, doctors, nurses and staff in the Special Care Nurseries come together with the “preemie graduates” and their families to celebrate life and renew acquaintances at the hospital’s annual “Preemie Party.” The Special Care Nurseries held its 27th annual Preemie Party with more than 100 families in attendance.

It’s a time for grateful family members to once again thank those who cared for their babies when they were so fragile and sick. And it’s a time for the hospital staff to see how the little ones are growing – many now toddlers, school-aged children, teenagers and some even in their 20s return.

Ann Critz, MD, chief of Pediatrics and medical director of Nurseries at EUHM, says, “This annual party gives us the opportunity to visit with ‘our babies’ and their families again to see the progress they’ve made since leaving the hospital. It’s wonderful to see these children developing and thriving now, when they were once so small and medically fragile. This gathering is a very sentimental time for me each year.”

Critz, who is an associate professor of pediatrics, Emory School of Medicine, has cared for hundreds of preemies during her 29-year tenure at Emory University Hospital Midtown.

Susan Horner, RN, nurse in the Special Care Nurseries and Preemie Party coordinator, says, “It’s a joy to reconnect with the little ones and their family members who spent so many hours in our nurseries nurturing their preemies before taking them home.”

All babies born at the hospital, including preemies, experience a concept called “family-centered care,” which encourages parents to assist in caring for, rocking, holding and feeding their babies daily. Despite all of the tubes and monitors needed for the preemies, this family-centered care is vital.

Critz notes that the technique is extremely important in the neonatal intensive care unit, called the NICU. Bonding with even the smallest infants in the early stages is critical for the baby’s development. She and her colleagues have found the more parents are involved with the care of their preemies, the better the babies thrive.

EUHM has been a leader in neonatal care for as far back as the 1940’s. The hospital’s NICU opened in 1981 and currently serves as part of the Emory Regional Perinatal Center, one of six regional perinatal centers in the state to care for high-risk infants. Learn more about the maternity center at EUHM.

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Obesity ups risk for endometrial cancer

Increasing numbers of obesity in both men and women nationwide are resulting in a growing rate of multiple health consequences. Recent research suggests that overweight women are at an increased risk of developing endometrial cancer, especially if menopause occurs in women younger than age 45.

One study has found that women with a body mass index (BMI) of greater than 35, who experienced their last menstrual period at an age younger than 45, had more than 20 times the risk of developing endometrial cancer than normal-weight women.

BMI is a measure of body fat based on height and weight that applies to both adult men and women. A BMI of 18.5 to 24.9 is considered normal weight, 25 to 29.9 is considered overweight and a number over 30 is considered obese.

Mary Dolan, MD, MPH, assistant professor of gynecology and obstetrics, Emory School of Medicine, notes that experts already know that obesity is linked to cardiovascular disease, high blood pressure, diabetes, joint complications and other diseases. Now the connection between obesity and endometrial cancer is on experts’ radar.

Mary Dolan, MD, MPH

Mary Dolan, MD, MPH

Endometrial cancer forms in the tissue lining the uterus or endometrium – the lining that is “shed” monthly during menstruation. Endometrial cancer is more common in older women and fortunately is usually diagnosed early since it causes abnormal bleeding, says Dolan.

In a report published recently, Dolan and colleagues from the Centers for Disease Control and Prevention (CDC) discuss findings from a review of data from the Cancer and Steroid Hormone study from the 1980s. This study examined the relationship between oral contraceptive use and breast, ovarian and endometrial cancers in women ages 20-54 years.

Since many of the study patients with endometrial cancer were overweight, the study gave researchers an opportunity to look at the risk for endometrial cancer among younger, overweight women using BMI.

The study found that women who were younger than 45 when they had their last period and had a BMI over 35 had a 21.7 times greater risk of developing endometrial cancer than a woman of normal weight.

In comparison, older women with a BMI of 35 or higher, who had their last period at age 45 or older, had a 3.7 times greater risk of developing endometrial cancer than a woman of normal weight.

Elevated risks were also seen for women who had been overweight or obese at age 18 and who had their last period before age 45.

Dolan says obesity can lead to higher levels of estrogen because of chronic “anovulation,” where a woman fails to ovulate. Because the condition brings on irregular or no menstruation, estrogen levels remain high while opposing progesterone levels remain low. Experts believe this combination leads to an increased risk of endometrial cancer.

Dolan says physicians need to counsel patients even more to maintain a healthy weight. By both losing weight and then maintaining it, a woman’s risk for endometrial cancer likely decreases.

This study is one of only a few which have focused on younger women and the relationship between obesity and endometrial cancer. The results were published in the July 2009 issue of Obstetrics & Gynecology

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