Down Syndrome - High Risk Mothers And Early Detection By Anne Clarke

As an expecting mother, please be sure to keep all doctor's appointments, take all prenatal vitamins and dietary supplements, and be absolutely certain to begin taking care of your child from the moment you find out you're pregnant. Prenatal care is essential for any expecting mother. Down Syndrome, as a primary concern for pregnant women over the age of 35, or for women genetically predisposed to give birth to a child with this condition, can sometimes be detected as early as the first trimester. Please see your doctor regularly and as soon as possible for an ultrasound.
Although there is not much that advanced medicine, as of yet, can do to prevent this troubling disease, there are ways a woman can prepare herself and her family to care for a child with Down Syndrome. This, of course, applies to many pregnancies and potential birth defects, such as Trisomy-18 and other chromosomal abnormalities that may occur. Taking care of yourself while you are pregnant is the most important thing you can do.
Any pregnancy is important, and many variables are certainly worth attending to during those crucial months before your child is born. Whether it has already been determined that yours is a high-risk pregnancy, or if you may possibly be a high-risk pregnancy, even if (as far as you know) you and your baby are in perfect health, medical attention is essential from the earliest possible point in your pregnancy.
One very important thing to do, in addition to all other prenatal care, is to have an ultra-screen done in your first trimester. An ultra-screen is a procedure that has been extensively studied. Screening is recommended for all pregnant patients, not just women over the age of 35. Of all Down Syndrome pregnancies, 91 percent can be detected by use of an ultra-screen in the first trimester. There is, however, a five percent chance of getting a false-positive result, therefore, if the first ultra screen is positive, reschedule another to be sure. If the screening detects a Trisomy-18 defect it is likely to be accurate. The false-positive rate on the ultra screen for Trisomy-18 is more like one percent. The ultra screen can detect, incredibly early, the chances of Trisomy-18 with up to 98 percent accuracy.
So, some of you eager expecting mothers are probably wondering, how exactly is the ultra-screen test performed? A combination ultrasound and blood test are keys to this procedure and the accuracy of its results. According to experts who routinely use the equipment, "the test begins with an ultrasound examination between 11w1d and 13w6d gestation." The CRL needs to be between 45 and 84 mm. CRL is measured for accurate pregnancy dating (i.e. the date of conception) and nuchal translucency (NT) is measured as well before the procedure can be performed. NT is a specific marker for chromosomal aneuploidy which can be detected by this procedure. At the time of the ultrasound exam, the doctors will collect a dried blood sample via fingerstick.
Along with the dried blood sample taken, the ultrasound data is entered onto the test requisition form and sent to laboratories for complete analysis. The blood sample is screened for free Beta HCG and Plasma Protein A(PAPP-A), a pregnancy-associated plasma protein. The risk for Down Syndrome in the fetus as well as the risk for Trisomy-18 are calculated based on the patent's age, the nuchal translucency, as well as the freebeta and PAPP-A. Despite the medical jargon that is sometimes difficult to get around, get the ultra-screen in your first trimester, and ask your doctor specific questions no matter how much you don't understand. The number one objective is to understand as much as you possibly can when it comes to your unborn child.

Anne Clarke writes numerous articles for Web sites on gardening, parenting, fashion, and home decor. Her background also includes health and fitness. For more of her useful articles on pregnancy and breastfeeding, please visit Breast Pumps, supplier of breastfeeding information and supplies.

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Polycystic Ovary Syndrome

 Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandro-
genism, ovulatory dysfunction, and polycystic ovaries. Its etiology remains
unknown, and treatment is largely symptom based and empirical. PCOS has the
potential to cause substantial metabolic sequelae, including an increased risk of
diabetes and cardiovascular disease,and these factors should be considered when
determining long-term treatment. The purpose of this document is to examine the
best available evidence for the diagnosis and clinical management of PCOS.
Background
Incidence, Definition, and Diagnostic Criteria
There is no universally accepted definition of PCOS and expert generated diag-
nostic criteria have proliferated in recent years (see Table 1). The Rotterdam cri-
teria, which supplanted the National Institutes of Health (NIH) diagnostic
criteria (1),incorporated the appearance of the ovary based on ultrasound exam-
ination into the schema (2). Ultrasound criteria for the diagnosis of polycystic
ovaries were decided by expert consensus (see Box 1) (3). These criteria have
been criticized for including more mild phenotypes, which increases the preva-
lence of PCOS and may complicate treatment decisions. The Androgen Excess
Society (AES) criteria recognizes hyperandrogenism as a necessary diagnostic
factor, in combination with other symptoms of the syndrome (4). Hyperandro-
genism can be established on the basis of clinical findings (eg, hirsutism or
acne) or serum hormone measurement. All diagnostic approaches recommend
that secondary causes (such as adult-onset congenital adrenal hyperplasia,
hyperprolactinemia,and androgen-secreting neoplasms) should first be excluded.
All diagnostic schemes also require more than one sign or symptom (Table 1,
Box 3). Polycystic ovaries alone,for example,are a nonspecific finding and also
are frequently noted in women with no endocrine or metabolic abnormalities.



ACOG JOURNAL

Pacquiao Vs Mayweather

Pacquiao Vs Mayweather

While we are watching their preparation before their match, now we got another suprising news.
Mayweather requesting for a drug thest for both of them, so there will be no question about it.
But why now? Why the other challenger og Pacquiao never requested this before?
Some people react that it was not necessary, esspecially the request come from the challenger.
Is this request makes senses?

he request by Floyd Mayweather for both he and Manny Pacquiao to potentially be blood tested as close as 48 hours from their possible March superfight is both unprecedented and unnecessary.


Pacquiao’s de facto manager told Yahoo! Sports’ Kevin Iole that Pacman will be blood tested one month out and just after the possible March 13 fight in (likely) Las Vegas. That schedule should answer any possible doping questions about Pacquiao (or Mayweather). The 48-hour deadline is a classic Mayweather psychological ploy, a little edge designed to get into his opponent’s
hat said, at this point, with the debate this far along, Pacquiao should just suck it up and agree to it.
Mayweather is a master at putting opponents in bad positions, both inside and outside the ring. Pacquiao is in one now, outfoxed by Mayweather in the fight negotiations. There’s no way Pacquiao can explain walking away from one of the biggest bouts in boxing history because, as his promoter suggests, he’s afraid of needles.
Do that and it isn’t just the game of boxing that takes a beating – it’s also Pacquiao’s reputation. The semantics about boxing standards or steroid cycles or unfair negotiations won’t break through what would, no doubt, be a vocal hammering from critics, none louder than from the Mayweathers.
“For that kind of money, how could you not take a test?” Floyd’s father, Floyd Mayweather Sr., has already crowed to the Grand Rapids (Mich.) Press.
Indeed, how do you not take a test?
The Mayweather camp has been outspoken in its suspicions about Pacquiao and performance-enhancing drugs. So it demanded that both fighters possibly submit blood samples to the United States Anti-Doping Agency in the days before and after the fight. When to test would be up to USADA. Pacquiao’s promoter, Bob Arum, said they’d stick to State of Nevada regulations, although Pacquiao’s adviser, Michael Koncz, said they’d do blood samples, just not that close to the fight.
That isn’t good enough, so far, for the Mayweather camp. If no one budges, boxing may be in the process of shooting itself in the foot, walking away from an event that already has fans worldwide buzzing in anticipation. More likely: Something gets worked out in time for a fight announcement in early January.
“In a fight of this magnitude, I think it is our responsibility to subject ourselves to sportsmanship at the highest level,” Mayweather Jr. said in a statement.

Manny Pacquiao’s team, which includes promoter Bob Arum, left, and trainer Freddie Roach, has been put into a corner over needles and blood testing.

“We’re going in a different direction,” Arum told the Grand Rapids Press. “What I believe is that Floyd never really wanted the fight and this is just harassment of Pacquiao.”
There’s little doubt this is harassment of Pacquiao. What else would you expect from Floyd Mayweather? He’s the master at screwing with opponents. Making Pacquiao discuss PEDs in the run up to the fight is a potential distraction – even if he’s clean. That was, no doubt, a goal when his camp requested aggressive doping standards.
This isn’t Mayweather’s normal bluster, though. He’s on the moral high ground here. The Pacquiao camp can hate the situation it finds itself in and may be correct that the requests are mostly ridiculous. It doesn’t change the reality of the debate.
If Pacman pulls out of the fight because of the timetable for doping tests, he’ll have a near-impossible challenge proving he isn’t trying to hide something.
Arum isn’t doing Pacquiao any favors with some of his silly excuses. He said Pacquiao is squeamish about needles, which is a heck of a thing to blow up a contest to determine the toughest pound-for-pound fighter on the planet.
He added that Pacquiao thinks a blood test within 48 hours of the fight might drain him, although most such tests take very little actual blood. Then there’s Arum’s claim that every doctor in the world would say doing such a thing is “stupid” and blood tests don’t “prove anything.” That’s hyperbole.
“Manny Pacquiao doesn’t know anything about drugs,” Arum told the Grand Rapids paper. “This is just typical nastiness by wise guys like [Mayweather Promotions CEO Leonard] Ellerbe and Mayweather.”
Nastiness? Sure. Wise guys? Absolutely. The Mayweather camp doesn’t play around. However, to say we have to just take Arum’s word that Pacquiao doesn’t know anything about drugs is absurd. There hasn’t been a reason to believe anything or anyone in sports on this topic in years. PED scandals in baseball, football, cycling, track, swimming and so on aren’t Pacquiao’s fault, but that’s the sporting reality he lives in.
He can’t just pretend fan suspicion isn’t reasonable.

Floyd Mayweather Sr. has taken his shots against Pacquiao over the past year.
(Getty Images)

Pacquiao has been a breath of fresh air for boxing and he’s never failed a drug test in his 50-3-2 career. The chance to see a man of similar speed and skill finally challenge the unbeaten Mayweather (40-0) has reenergized the sport.
Which doesn’t mean either fighter is above reproach. The Mayweathers have had no problem voicing their concerns about Pacman’s ability to maintain punching power and punch-taking ability as he has climbed through weight classes (even as Mayweather has made a similar journey).
Regardless, in one of their typically deft maneuvers, they demanded extreme testing standards that left the Pacquiao camp backpedaling and debating an issue they can’t win.
What Mayweather is calling for may be unfair, but is Pacquiao going to give up tens of millions of dollars and a chance to cement his legacy as one of the all-time greatest fighters out of principle?
Is he going to bail knowing that he opens himself up to questions about PEDs because, despite being tough enough to let Miguel Cotto unload on him, he’s scared of a needle?
Floyd Mayweather has cornered him on this one, doing what he does best, making the fight get fought on his terms. The way to stop Mayweather, though, has always been to punch back – hard.
Instead, Manny Pacquiao is going to walk away?

Health Care Reform Bill Still Sparking Disputes

Will this reformation will showed it result? I hope .......

What will it effect on most people??? Will it??

What do you think about this reformation? Please shared your opinion here.

Last night's vote in the Senate sent its watered-down version of health care reform on to the next step in the sausage-making process. And while reform advocates seemed to cheer the end result last night -- at least from my decidedly imperfect vantage, which was monitoring the vote via Twitter while standing on line for a cab at Union Station -- here on the morning after, plenty of divisions remain between those who want to propel this imperfect bill forward and those who want it scrapped.
Over at Firedoglake, Jane Hamsher doesn't see the Senate bill as either effective or the beginning of something effective: "The Senate bill isn't a 'starter home', it's a sink hole." Hamsher goes on to list the "Top 10 Reasons to Kill Senate Health Care Bill".

1. Forces you to pay up to 8% of your income to private insurance corporations -- whether you want to or not.
2. If you refuse to buy the insurance, you'll have to pay penalties of up to 2% of your annual income to the IRS.
3. Many will be forced to buy poor-quality insurance they can't afford to use, with $11,900 in annual out-of-pocket expenses over and above their annual premiums.
4. Massive restriction on a woman's right to choose, designed to trigger a challenge to Roe v. Wade in the Supreme Court.
5. Paid for by taxes on the middle class insurance plan you have right now through your employer, causing them to cut back benefits and increase co-pays.
6. Many of the taxes to pay for the bill start now, but most Americans won't see any benefits -- like an end to discrimination against those with preexisting conditions -- until 2014 when the program begins.
7. Allows insurance companies to charge people who are older 300% more than others.
8. Grants monopolies to drug companies that will keep generic versions of expensive biotech drugs from ever coming to market.
9. No re-importation of prescription drugs, which would save consumers $100 billion over 10 years.
10. The cost of medical care will continue to rise, and insurance premiums for a family of four will rise an average of $1,000 a year -- meaning in 10 years, your family's insurance premium will be $10,000 more annually than it is right now.

The Washington Post's Ezra Klein doesn't see it that way, and counters by saying that while the bill "that looks likely to clear the Senate this week is not very close to the health-care bill most liberals want... it is very close to the health-care bill that Barack Obama promised."

...there are, to be sure, some differences. The public option did not survive the Senate. The individual mandate, which Obama campaigned against, was added after key members of Congress and the administration realized that the plan wouldn't function in its absence. Drug reimportation was defeated, and a vague effort to have government pick up some catastrophic costs was never really mentioned.
But the basic structure of the proposal is remarkably similar. Here's how it was described in the campaign's white paper:

The Obama-Biden plan provides new affordable health insurance options by: (1) guaranteeing eligibility for all health insurance plans; (2) creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance; (3) providing new tax credits to families who can't afford health insurance and to small businesses with a new Small Business Health Tax Credit; (4) requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan; (5) requiring all children have health care coverage; (5) expanding eligibility for the Medicaid and SCHIP programs; and (6) allowing flexibility for state health reform plans.

This is about where the debate is right now, with some willing to settle and other angry that the administration -- by not attempting to do more politicking in advance of last night's vote -- gave up too much. As I wrote last week, my main problems with the bill are that while it may comport to the campaign's white paper, it falls far short of the promises made on the campaign trail. That's why I suspect that the one thing the passage of a reconciled health care reform bill will not achieve is to end the need for substantial health care reform.

 

Cervical Cytology Screening

Cervical Cytology Screening
CLINICALMANAGEMENTGUIDELINESFOROBSTETRICIAN–GYNECOLOGISTS
NUMBER109, DECEMBER 2009
(Replaces Practice Bulletin Number 45, August 2003, Committee Opinion Number 300, October 2004, and Committee Opinion Number 431, May 2009)


The incidence of cervical cancer has decreased more than 50% in the past 30  years because of widespread screening with cervical cytology. In 1975,the rate was 14.8 per 100,000 women in the United States; by 2006,it had been reduced to 6.5 per 100,000 women. Mortality from the disease has undergone a similar decrease (1). The American Cancer Society estimates 11,270 new cases of cer-
vical cancer in the United States in 2009, with 4,070 deaths from the disease (2). Recent estimates worldwide,however,are of almost 500,000 new cases and 240,000 deaths from the disease per year (3). When cervical cytology screening programs have been introduced into communities,marked reductions in cervical cancer incidence have followed (4–6). New technology for performing cervical cancer screening is evolving rapidly, as are recommendations for classifying and interpreting the results. The purpose of this document is to provide a review of the best available evidence on screening for cervical cancer. Specific equipment and techniques for performing cervical cytology and interpretation of the results are not discussed.



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JOURNAL

Posting again!!!

After a very busy month,
Thanks God we can finish all the exams and the accredititation.
Hope i can post a new joournal soon...
I forgot my rapidshare account hahahahahaha...