Medical Monday: Breaking News form the World of Obstetrics and Gynecology

Good Monday. The administrative wheels are beginning to turn in response to the Zika virus. In particular, the CDC(Centers for Disease Control) and OSHA( Occupational Health and Safety Administration) have issues interim guidelines for employers and workers who are in settings which increase their risk for contracting Zika virus. This includes workers in outdoor settings, travel or health care settings. Guidelines deal primarily with protective clothing and the correct use of EPA approved insect repellent. Additionally the CDC has activate the Emergency Operations Center to Level 1. This means the CDC assigns the largest number of staff possible to work 24/7 on the response. To date so far, there have only been three other Level 1 responses, to Ebola, H1N1, and Hurricane Katrina. Experts in Brazil have come to understand that the perinatal consequences ot Zika go beyond microcephaly. It has been found to " erode the fetal brain"...destroying the lobes which control vision and thought an other basic functions. Moreover, Zika appears to prevent formation of areas of the brain "not yet formed". 

Meanwhile the House and the Senate continue to debate about what is the “ right number” for money to fund the efforts to handle the Zika crisis. 

At the same time researchers at NASA and NCAR ( National Center for Atmospheric Research) have made themselves exceptionally useful and, lacking an adequately absorbing space mission, have created a month to month map model which plots risk of Zika in US cities. The map does this by taking into consideration climate and population factors and how they affect the prevalence of the carrier of Zika, the Aedes Aegyptae mosquito. These maps really brings the situation into focus. Have a look HERE

Beast cancer risk prediction may be about to improve. New research presented at the American Cancer Society annual research meeting suggests that adding  “ genetic risk score” together with mammography density and hormone levels to current models will improve predictions. Improved predictions are help us devise tailored screening regimens for individual patients of varying risk. Hormones will be assessed only in postmenopausal women not taking andy hormone therapy. In these women, they plan to sample estrogen, testosterone and prolactin. Adding these markers improved risk prediction somewhere between 6 and 10 fold. 

The FDA (Food and Drug Administration) has recommended that there is a possible new link between flucaonazole (Diflucan) and miscarriage. This possible link is restricted to high dose or extended therapy regimens, not the 150 mg single dose most commonly prescribed. However, in response to this warning, the CDC is recommending the use of topical products only in pregnant woman. 

All you moms know it , I know it, and now science knows it. Mom brain notwithstanding, healthy new mothers are smarter, faster and more resilient than their pre-pregnancy selves. Older research has demonstrated this. Now the journal Behavioral Neuroscience has published research using sequential MRI studies of new mothers’ brains. They have found increases in grey matter in the prefrontal cortex and the parietal lobes and others between about 2 weeks postpartum and 3 months postpartum. These are areas which have to do with emotional regulation, survival instincts and hormones. 


Stay tuned for more breaking news from the world of Obstetrics, Gynecology and Women’s Heath.