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Wednesday, April 24, 2013

The Flu Shot Trifecta Protects Mom, Fetus and Infant

If you’re pregnant and haven’t gotten a flu shot it’s time to get one, says Geeta Swamy, who recommends pregnant women get the vaccine each year, whether their pregnancy falls before, during and even after the flu season peaks.

“Maternal immunizations protect the mother, but have an even greater potential impact on your baby,” says Swamy, a nationally recognized expert on immunizations during pregnancy. “It’s only one vaccine but it has three very important benefits – it protects the mom, it protects the fetus by preventing the risks of preterm delivery and low birth weight, and it protects the newborn before he or she is old enough to be vaccinated.”

While pregnant women are not at higher risk for getting the flu, they are more likely to suffer serious complications, Swamy says. Data show pregnant women are more likely to be hospitalized; and they have higher rates of pneumonia, respiratory complications and death related to the influenza infection.

The risks to the unborn child are just as severe.

“Babies who are exposed to influenza during the mother’s pregnancy may suffer from long-term implications,” says Swamy. “Even if mom is fine, there is some evidence to suggest that influenza exposure can lead to medical problems that include psychiatric disorders in the baby’s future.”

Swamy stresses that pregnant women who get a flu shot are not exposing their fetus to the infection. Rather, they are transferring antibodies against influenza to their unborn baby. That reduces the infant’s risk of contracting the flu before they are old enough to be vaccinated.

The ability to transfer antibodies in utero is also important for other infections like pertussis, also known as whooping cough, which has reached epidemic proportions in some states. “The Centers for Disease Control now recommends that women get the pertussis vaccine during each pregnancy to protect their unborn child,” says Swamy.

Since no immunization is perfect, pregnant women who have been vaccinated against the flu should continue to take precautions. “If you think you have been exposed, we can offer prophylactic treatment with anti-virals,” says Swamy. If you experience flu-like symptoms, including severe headache, malaise, fever and body aches, call your doctor.

“The ideal scenario is to obtain treatment within the first 48 hours,” says Swamy. That and a flu shot are your best lines of defense against a rampant infection that could have severe consequences for you and child. 

Wednesday, April 17, 2013

Primary Immunodeficiency Diseases

One of the most important functions of the immune system is to protect us from bacteria, viruses, and fungi that can make us sick. Not all organisms are harmful--in fact, our intestines contain many bacteria that help prevent problems such as allergies and improper absorption of nutrients. The immune system identifies the difference between what is dangerous and what is not and prevents whatever is dangerous from harming us. Primary immunodeficiency diseases (PIDDs) are caused by mutations in genes that prevent the body from developing normal immune responses to infectious challenges. The mutations can either be inherited or appear randomly.  Because the immune system is compromised in PIDDs, harmful organisms usually cause recurrent and sometimes life-threatening infections.  In addition, since these diseases are genetic, they are generally considered to be lifelong conditions once they are diagnosed.

How common are primary immunodeficiency diseases?

The most common PIDD is selective IgA deficiency, which has been reported as frequently as about one in every 300 to 400 individuals in the United States.  Although other PIDDs may occur less frequently, the actual rates of occurrence are not known because positive diagnoses are often not made.  As screening of newborns for important PIDDs becomes implemented as a standard practice, these statistics should become more accurate.

What are the signs and symptoms of primary immunodeficiency diseases?

Signs and symptoms that often alert us of the possibility of a PIDD are well-summarized by the following "10 Warning Signs of Primary Immunodeficiency":

    Four or more new ear infections within one year, particularly after the first year of life.
    Two or more serious sinus infections within one year.
    Two or more months on antibiotics with little effect.
    Two or more pneumonias within one year.
    Failure of an infant to gain weight or grow normally.
    Recurrent, deep skin or organ abscesses.
    Persistent thrush in the mouth or significant fungal infections on the skin.
    Need for intravenous antibiotics to clear infections.
    Two or more deep-seated infections, including infections of the bloodstream.
    A family history of primary immune deficiency.

How are primary immunodeficiency diseases treated?

Our patients are often given antibiotics or antifungal medications for prevention or treatment of infections. These medications need to be prescribed carefully because they can sometimes cause unwanted side effects or encourage the growth of bacteria that are resistant to antibiotics. Patients who lack the ability to make antibodies often require immunoglobulin replacement therapy.  Some patients, depending on the type of PIDD that has been diagnosed, may require bone marrow or umbilical cord stem cell transplantation or even thymus transplantation in the most severe cases. Sometimes it may be treated with anabolic steroids.

Tuesday, April 9, 2013

Urinary Tract Infection in Adults

A urinary tract infection, or UTI, is an infection that can happen anywhere along the urinary tract. Urinary tract infections have different names, depending on what part of the urinary tract is infected.

Causes, incidence, and risk factors:

Urinary tract infections are caused by germs, usually bacteria that enter the urethra and then the bladder. This can lead to infection, most commonly in the bladder itself, which can spread to the kidneys.

Most of the time, your body can get rid of these bacteria. However, certain conditions increase the risk of having UTIs.

Women tend to get them more often because their urethra is shorter and closer to the anus than in men. Because of this, women are more likely to get an infection after sexual activity or when using a diaphragm for birth control. Menopause also increases the risk of a UTI.

The following also increase your chances of developing a UTI:

    Diabetes
    Advanced age (especially people in nursing homes)
    Problems emptying your bladder completely (urinary retention)
    A tube called a urinary catheter inserted into your urinary tract
    Bowel incontinence
    Enlarged prostate, narrowed urethra, or anything that blocks the flow of urine
    Kidney stones
    Staying still (immobile) for a long period of time (for example, while you are recovering from a hip fracture)
    Pregnancy
    Surgery or other procedure involving the urinary tract

Tuesday, April 2, 2013

How are Viral Diseases Treated?

Viral diseases are extremely widespread infections caused by viruses, a type of microorganism. There are many types of viruses that cause a wide variety of viral diseases. The most common type of viral disease is the common cold, which is caused by a viral infection of the upper respiratory tract.

Treatment of viral infections varies depending on the specific virus and other factors. General treatment measures are aimed at relieving your symptoms so that you can get the rest you need to keep up your strength and recover without developing complications.

General treatments for viral infections include:

    Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for fever, body aches, and pain

    Drinking extra fluids

    Getting extra rest and sleep

    Maintaining good nutrition

Depending on the type of viral infection and the presence of complications, a wide variety of other treatments may be needed. For example, a human papillomavirus (HPV) infection that leads to cervical dysplasia can be treated by surgical removal of the abnormal cells on a woman’s cervix.  

In general, it is recommended that children younger than age six not use cold or cough medications because of the risk for serious side effects. In addition, people with a viral disease should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as a cold or the flu.