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Would-be moms often want to know how to trim their bellies after having children. But how actively do they seek tips for getting their bodies in great shape before getting pregnant?

Until recently, that part of the baby-making equation had been largely absent from the discussion. Increasingly, though, maternal health and prenatal-care experts are urging women to improve their health before conceiving.

The hope is that measures taken to bolster a woman's health prior to conception -- whether it's reaching an optimal weight, controlling a chronic disease or boosting overall nutritional health -- will improve the odds of having an uncomplicated pregnancy and a healthy baby.

Dr. Lorey H. Pollack, director of obstetrics and gynecology at Mercy Medical Center in Rockville Centre, N.Y., has some patients who are very informed and motivated to take better care of themselves before contemplating pregnancy. Others, though, come in pregnant and say, "By the way, I have diabetes; by the way, I have Lupus; by the way, I have high blood pressure, and they're kind of shocked to find out that's an issue when they're pregnant," he said.

Pollack blames the medical profession and the media for failing to get the word out.

But recommendations compiled by experts at the U.S. Centers for Disease Control and Prevention as well as more than 35 government, public and private partners may help to draw attention to the importance of preconception care.

Dr. Hani K. Atrash, associate director for program development at the CDC's National Center on Birth Defects and Developmental Disabilities and co-author of the government report, said, "If a woman or couple has decided to conceive, then at least one pre-pregnancy visit is recommended, and the five most important things to do are":
- Take 400 micrograms of folic acid a day for at least three months before pregnancy to reduce the risk of birth defects.
- Stop smoking and drinking alcohol.
- Consult with a health-care provider to manage any and all medical conditions, including, but not limited to, asthma, diabetes, oral health, obesity, or epilepsy, and maintain up-to-date vaccinations.
- Talk to your doctor and pharmacist about any over-the-counter and prescription medicines you are taking, including vitamins and dietary or herbal supplements.
- Avoid exposure to toxic substances or potentially infectious materials at work or at home, such as chemicals, or cat and rodent feces.
- Atrash was also co-editor of a special supplement of the Maternal and Child Health Journal, published last September, devoted entirely to the topic of preconception care.

"It's always easier to try to prevent a problem than to catch up with it later on," he reasoned.

More information
For more on preconception health, visit the American Pregnancy Association.

Sourse - HealthDay News

| Tags: Pregnancy, Relationships, Women's Health |

Labels: Asthma, Children's Health, Diabetes, Nutrition, Oral Care, Pregnancy, Public Health, Relationships, Women's Health

A gene that is strongly associated with a risk of developing childhood onset asthma was identified by an international team of scientists, whose findings are published Wednesday in the journal Nature.

In a genetic study of more than 2,000 children, scientists from the University of Michigan and colleagues from London, France and Germany found genetic markers that dramatically increase a child's risk for asthma.

These markers are located on chromosome 17, and children with this marker had higher levels of a new gene called ORMDL3 in their blood, which occurs in higher amounts in children with asthma. The presence of the disease-associated version of ORMDL3 increases the risk of asthma by 60-70 percent, the study suggests.

"In terms of an asthma gene, there have been quite a few reports but not one that can be clearly reproduced in samples," said Goncalo Abecasis from University of Michigan School of Public Health.
"I think eventually it will lead to new therapies because it points to a specific biological molecular pathway. Once we understand the biology and we know the players, it's possible to target with specific drugs."

Sourse - Xinhua

| Tags: Allergy, Asthma, Children's Health |

Labels: Allergy, Asthma, Children's Health, Public Health

The use of antibiotics in the first year of life is associated with an increased risk for asthma at age 7, a new study has found, and the reason may be that antibiotics destroy not only disease-causing microbes, but also those that are helpful to the developing immune system.

Antibiotic use had a greater impact on children who would otherwise be considered at lower risk — children who lived in rural areas and those whose mothers did not have asthma — than on those who were already at increased risk because of an urban environment or genetic predisposition.

Studies of antibiotic use and asthma have been complicated. Because antibiotics are used to treat respiratory illnesses, which are often precursors of asthma, it has been difficult to determine the effect of antibiotics alone. But this study, of 13,116 Canadian children, found that the risk of asthma increased even in children treated with antibiotics for nonrespiratory illnesses in the first year of life. The study appears in the June issue of Chest.

Anita Kozyrskyj, the lead author and an associate professor of pharmacy at the University of Manitoba, said the findings supported what scientists call the microflora hypothesis — that "you need good bacteria in your digestive tract for normal development of the immune system so that you don't end up with asthma," as she put it.

The researchers tracked medications by examining prescription records, and determined asthma status by treatment for asthma or any asthma drug use in the year following the seventh birthday. Six percent of the children developed asthma by age 7.

| Tags: Asthma, Children's Health |

Labels: Asthma, Children's Health, Digestive

A cough is considered chronic if it persists for longer than 3 weeks. In the nonsmoker with a chronic cough who is not taking angiotensin-converting enzyme (ACE) inhibitors and who has a normal chest radiograph, one of three diagnoses is likely: postnasal drip syndrome (PNDS), asthma, or gastroesophageal reflux disease (GERD). Many patients have more than one cause (1,2,3 and 4).


I. Cough due to postnasal drip.

Presentation
Singly or in combination with other conditions, PNDS is the most common cause of all chronic cough. This syndrome is due to a variety of upper airway conditions including the common cold, allergic rhinitis, vasomotor rhinitis, postinfectious rhinitis, rhinitis due to environmental or medication irritants, and acute and/or chronic (bacterial) sinusitis. These various entities overlap and may best be called rhinosinusitis.

Diagnosis
There are no definitive diagnostic criteria for PNDS. A favorable response to therapy is the best way to make the diagnosis. Allergy testing can be helpful in some patients, but positive skin tests do not prove that allergy is the cause. Direct nasolaryngoscopy may also be useful. A four-view sinus radiograph or, preferably, a sinus coronal CT scan will show the presence of chronic sinusitis, provided it is obtained at least 6 weeks after an acute episode to avoid false positives (3).

Management
Empirical therapy for PNDS should be tried before beginning an extensive diagnostic workup. For vasomotor or postinfectious rhinitis, the older generation of antihistamine/decongestants has been shown to be effective (4). To reduce side effects, initiate therapy at bedtime. The newer generation antihistamines, either alone or in combination with pseudoephedrine, have not been shown to reduce cough associated with the common cold. The use of ipratropium or azelastine nasal sprays (2 sprays in each nostril bid) may also be effective. For PNDS due to allergic rhinitis, all oral antihistamines, nasal cromolyn, and nasal steroids are effective. Nasal steroids are the drug of choice and their administration may be necessary for at least 3 months. Antibiotics used to treat chronic sinusitis include amoxicillin (Amoxil) 500 mg tid, trimethoprim–sulfamethoxazole (Septra DS) bid, or erythromycin (Erythromycin Filmtab) 250 mg qid (all for 3 weeks); or azithromycin (Zithromax), two 250-mg tablets on day 1, followed by one tablet daily on days 2–5, with the regimen repeated after 1 week off. (See Chapter 8.5.) Nasal washes may also be helpful.


II. Cough variant asthma. (See also Chapter 10.1.)

Presentation
This entity is easily overlooked because breathlessness or wheezing may be minimal. A viral respiratory illness or a bacterial or atypical bronchitis may initiate this cough variant asthma. This postinfectious type of cough variant asthma is a common clinical occurrence. Seasonal or specific allergies can also precipitate this syndrome. The cough is usually nonproductive and occurs throughout the day and night.


III. Cough due to GERD

Presentation
Many patients with cough have typical gastrointestinal (GI) symptoms, such as sour taste, heartburn, and regurgitation. However, some have no GI complaints, and the reflux is only discovered upon workup (5).

Diagnosis
In patients with typical GI symptoms or those in whom a GI cause is suspected, 24-hour ambulatory esophageal pH monitoring is the best test. But first ask about a time of cought, if it is bedtime, you should think, GERD.

Treatment
The H2 antagonists, such as cimetidine (Tagamet) 800 mg qd or ranitidine (Zantac) 150 mg bid, are the mainstays of drug therapy (4). As some patients' symptoms may not improve for 2–3 months, long-term treatment may be necessary. Interestingly, both cough symptoms and reflux continue to be suppressed for more than 6 weeks after H2 blockers are stopped. Proton pump inhibitors, such as omeprazole (Prilosec) 20 mg qd to 40 mg bid, are also used and may be tried if there is no response to or poor toleration of H2 blockers. It is difficult to predict which patients will respond to therapy. Antireflux surgery, now frequently done by laparoscopy, is reserved for patients with continued symptoms who fail medical therapy, including proton pump inhibitors.

| Tags: Allergy |

Labels: Allergy, Asthma