Great Neck OBGYN

Obstetrics and Gynecology

» NIH Panel Convenes Committee On VBAC
» Pregnancy Weight Gain Increases Diabetes Risk
» Retracting A Medical Journal's Autism Study
» Dark Chocolate is Linked to Less Maternal Anemia
» Staples Tied To Increase In C section Wound Complications
» Cochrane Date: Food, Water In Labor OK In Low-Risk Women
» Novel Biomarker May Quickly Confirm Ectopic Pregnancy
» In Vitro Fertilization & Ovarian Cancer Risk Study
» Increased Pregnancy Loss Rate in Thyroid Antibody Negative Women
» Effect of Alcohol Consumption On In Vitro Fertilization
» Placebo-controlled Trial Of Indole-3-Carbinol In Treatment Of CIN
» Cruciferous Veggies Boost Survival in Breast Cancer Patients
» Soda Linked to Aggression & Inattention in Kids
» Sadaty Named Best of Long Island: OB/GYN
» Great Neck OBGYN Now Offering Femilift

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Sadaty Named Best of Long Island

Dr. Anita Sadaty was named one of three Best OB/GYN Long Island

Best OBGYN Long IslandDr. Anita Sadaty was named among three others as the Best Of Long Island in OB/GYN category. Identifying top quality among the countless practices throughout Long Island is no small endeavor, and these days, even with the economy on the uptick, knowing where your money will be best spent is more important than ever. For nearly a decade, the Best of L.I. program has provided a roadmap to the best, top-notch businesses and services throughout both Nassau and Suffolk counties, as chosen by you, the residents and patrons who rely on them, every single day.

Part of a woman's wellness is making sure she is healthy and being proactive. Fertility is important if she wants to have children, and visiting an obstetrician and gynecologist regularly will help women be more aware of that aspect of their health. Some women may be shy when it comes to going to these specialists, but they are crucial for well-rounded wellness. So don't delay make your appointment with one the Best Obstetrics and Gynecology on Long Island today.

Best of Long Island

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Great Neck OBGYN Now Offering Femilift

New in-office procedure for vaginal pain, vaginal atrophy, dryness, recurrent vaginal infections, & urinary stress incontinence

The Femilift is a quick, safe, and highly effective in-office procedure for vaginal pain, vaginal atrophy, dryness, recurrent vaginal infections, and urinary stress incontinence. It is done without the need for anesthesia, medication, or hormones. It is virtually painless.

The vagina can lose collagen or tightness due to childbirth, aging or gravity. The Femilift uses a special laser that increases collagen and blood flow in the vaginal tissues. This helps to reduce vaginal laxity and improve sexual functioning. In addition, increased blood flow to the vagina increases lubrication, helps to maintain vaginal ph, and prevents recurrent infections.

Learn More: Femilift

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Cruciferous Veggies Boost Survival in Breast Cancer Patients

The consumption of cruciferous vegetables might have a positive impact on survival in breast cancer patients, according to the results of a new study.

The Shanghai Breast Cancer Survival Study, a large population-based prospective cohort study of Chinese breast cancer survivors, showed that eating cruciferous vegetables after a diagnosis of breast cancer was associated with improved survival in a population of Chinese women. The results were presented here at the American Association for Cancer Research 103rd Annual Meeting.

They observed that the risk for total mortality decreased by 27% (to 62%), the risk for breast-cancer-specific mortality decreased by 22% (to 62%), and the risk for recurrence decreased by 21% (to 35%).

MD commentary: Although differences in the populations need to be taken into account when trying to extrapolate these results to other settings, there is certainly scientific support for increasing one's intake of cruciferous vegetables (broccoli, bok choy, cabbage, cauliflower, brussel sprouts) in populations at risk for breast cancer recurrence.

Read the entire article.

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Soda Linked to Aggression & Inattention in Kids

Consumption of even one soft drink per day may be associated with increased negative behavior in young children, a new research suggests.

A cohort study of almost 3000 5-year-olds showed that those who drank 1 to 4 servings of soda per day had significantly higher aggressive measurement scores than their peers who drank no soda. In addition, those who consumed 2 or more servings had higher withdrawn behavior scores, and those who consumed 4 or more servings had higher attention problem scores.

"We were seeing a dose-response effect. So with every increase in soda consumption, the association and the scores basically increased," lead author Shakira Suglia, ScD, assistant professor of epidemiology at the Mailman School of Public Health at Columbia University in New York City, toldMedscape Medical News. "This held up even after we adjusted for candy or fruit juice consumption and for a variety of social factors, especially for aggression with the highest level of soda consumption," she added.

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Cruciferous Veggies Boost Survival in Breast Cancer Patients

The consumption of cruciferous vegetables might have a positive impact on survival in breast cancer patients, according to the results of a new study.

The Shanghai Breast Cancer Survival Study, a large population-based prospective cohort study of Chinese breast cancer survivors, showed that eating cruciferous vegetables after a diagnosis of breast cancer was associated with improved survival in a population of Chinese women. The results were presented here at the American Association for Cancer Research 103rd Annual Meeting.

They observed that the risk for total mortality decreased by 27% (to 62%), the risk for breast-cancer-specific mortality decreased by 22% (to 62%), and the risk for recurrence decreased by 21% (to 35%).

MD commentary: Although differences in the populations need to be taken into account when trying to extrapolate these results to other settings, there is certainly scientific support for increasing one's intake of cruciferous vegetables (broccoli, bok choy, cabbage, cauliflower, brussel sprouts) in populations at risk for breast cancer recurrence.

Read the entire article.

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Placebo-controlled Trial Of Indole-3-Carbinol In Treatment Of Cervical Intraepithelial Neoplasia (CIN)

A double-blind placebo-controlled study of indole-3-Carbinol. Thirty women with biopsy-proven cervical intraepithelial neoplasia (CIN) received placebo, 200 or 400 mg/day of I3C for 12 weeks. None of the patients in the placebo arm had complete regression of CIN, whereas 4 of 8 (p=0.023) from the 200 mg/day arm and 4 of 9 (p=0.032) from the 400 mg/day arm had complete regression after 12 weeks. The ratio of 2-hydroxyestrone to 16-alpha-hydroxyestrone changed in a dose-dependent fashion. The results of this study show promise for the use of I3C as a nonsurgical option for the treatment of CIN, although the data needs to be confirmed in a large multicenter trial.

Physician commentary: Indole 3 carbinol is a potent anti-oxidant that is a concentrated form of the cancer fighting agents found in cruciferous vegetables. According to this study, intake of I3C was associated with a significant increase in regression of cervical pre-cancerous cell changes. This is particularly exciting given the high incidence of pre-cancer of the cervix in the United States and gives women an opportunity to avoid any procedures on the cervix to treat these abnormalities.

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Effect of Alcohol Consumption On In Vitro Fertilization

A study out of brigham and women's hospital published in the January 2011 Obstetrics and Gynecology concludes that consumption of as few as 4 drinks per week is associated with a decrease in IVF live birth rate.

MD commentary: It is well known that alcohol use in pregnancy is linked to birth defects however the effects on fertility are not so well studied. Women who drank at least 4 drinks per week had a 16 percent lower likelihood of live birth compared to women who drank less. Interestingly the odds of having a live birth were 21% lower among COUPLES in which both members drank more than 4 drinks per week. We conclude that alcohol use at the time of IVF cycle start can have a negative effect on fertilization and live birth, and that men and women should modify this behavior to enhance their chances of a successful conception.

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Increased Pregnancy Loss Rate in Thyroid Antibody Negative Women With TSH Levels Between 2.5 and 5.0 in the First Trimester of Pregnancy

The study reports pregnancy outcomes in 4123 women who had their TSH (thyroid stimulating hormone) levels measured at the first medical visit during pregnancy. All pregnancies were singleton and spontaneously conceived. Two groups were created on the basis of TSH levels: < 2.5 mIU/l (n = 3481) and 2.5-5.0 mIU/l (n = 642). Age and parity were comparable. The mean gestational age for the first prenatal visit was also similar (between 8-9 weeks).

The pregnancy loss rate was 3.6% in women with a TSH level of < 2.5 mIU/l, and 6.1% in women with TSH levels between 2.5 and 5.0 mIU/l. This difference was statistically significant. Within the 2 TSH groups, age, obstetric history, and thyroid function test did not differ between those who miscarried and those who did not. The risk for miscarriage increased by 15% for each 1 mIU/l elevation of the TSH level on the basis of logistic regression analysis. The risk for preterm delivery and very preterm delivery did not differ on the basis of TSH levels.

MD commentary: This study underscores the need for optimization of thyroid function in women who are already diagnosed with underactive thyroid and also points to an additional screening tool for evaluating women with miscarriages not associated with chromosomal abnormalities.

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In Vitro Fertilization & Ovarian Cancer Risk Study

In a paper published in the journal Human Reproduction just a month ago, a very large database was examined. More than 24,000 women who had been treated with in vitro fertilization were studied, and the data show rather convincingly that although there is clearly an association between infertility and the development of ovarian cancer, women who had undergone in vitro fertilization compared with women who had infertility and had not undergone in vitro fertilization, there was in fact no increase in the risk for ovarian cancer. These are very important data, particularly for women who have experienced infertility and are considering in vitro fertilization — and all the benefits that clearly provides in terms of being able to have children — and this is very reassuring information that there is no increased risk for the development of ovarian cancer following this procedure.

MD commentary: It is often of concern for patients who have undergone infertility treatment with powerful hormone therapy that they may be increasing their long term risks for ovarian cancer. This large database supports the currently held opinion that the infertility treatment does NOT increase the risk for developing ovarian cancer above the background risk.

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Novel Biomarker May Quickly Confirm Ectopic Pregnancy

A new biomarker may result in earlier diagnosis of ectopic pregnancy, according to a study published recently in the Journal of Clinical Endocrinology & Metabolism.

Investigators proposed that ectopic pregnancies, or pregnancies that implant outside of the uterus (most commonly in the fallopian tube), may release smaller or different amounts of a placental tissue specific hormone than pregnancies that implant in the uterus. They conducted a small study of 40 women comparing the amount of PGIF, placental growth factor, found in the serum of women undergoing surgery for either pregnancy termination, miscarriage or removal of ectopic pregnancy. The investigators found that serum PIGF levels were not detected in tubal ectopic pregnancies and were limited or undetectable in miscarriage compared with terminated viable pregnancies.

This could be very useful in determining whether or not a pregnancy is normal very early in the process compared to current techniques that rely and serial ultrasound exams and serial bhcg pregnancy levels. Researchers recommend larger scale studies to determine if this would be helpful in the clincial setting.

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Staples Tied to Increase in C section Wound Complications

Staple closure at cesarean delivery was associated with more than a fourfold increased risk of wound separation compared with subcuticular closure according to a large prospective randomized study. The wound separation rate in the staple group was 17% compared to the suture group 5%. There were however similar rates of wound infection in both groups.

MD commentary: It is reassuring to know that a closure method that we have adopted as a group has been shown to result in fewer complications for our patients. The study did remark that more women in the staple group had more prior c sections, and a higher incidence of chorioamnionitis, which may be independent risk factors for wound separation to begin with...

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Cochrane Date: Food, Water in Labor OK In Low-Risk Women

In women at low risk of needing general anesthesia during childbirth, there was no significant association with eating and drinking during labor and the rate of cesarean delivery, operative vaginal birth, or Apgar scores of less than 7 at 5 minutes. A Cochrane database review of 5 studies comprising 3,130 women, concludes that women at low risk of complications during childbirth should be allowed to take food and water as they desire during the active phase of labor.

MD commentary: I applaud the move to open the discussion regarding such strict guidelines for the majority of low-risk women in labor. I think it is certainly reasonable to begin allowing a more flexible clear fluid drinking schedule and light eating in the early phases of labor. However, during active labor, it is difficult to predict which patient may turn into a high risk situation. It will be interesting to hear if ACOG begins to relax their recommendations given this analysis.

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Dark Chocolate is Linked to Less Maternal Anemia

A daily dosage of 30 grams of dark chocolate during pregnancy was associated with a lower blood pressures and a reduced risk of anemia. Yale University investigators reported that in a study including 2,291 pregnant women, dark chocolate consumption was associated with a lower risk of pre-eclampsia as well.

MD commentary: It's an appealing concept that a pleasure food actually may be associated with health benefits for pregnant moms.

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NIH Panel Convenes Committee On VBAC

The NIH Consensus Conference on Vaginal Birth After Cesarean has just released its findings offering strong support for a far more liberal policy regarding vaginal birth after C-section (VBAC). In 1980, after reviewing the scientific literature, an NIH panel recommended offering a trial of labor to women who had had a previous C-section. As a result, VBAC became popular. Many women had successful vaginal deliveries. Only a very small proportion of women had serious complications, almost exactly what was predicted. Yet the VBAC rate peaked in 1997 and has declined precipitously since.

Why did VBACs decline despite the fact that the benefits and risks were exactly as predicted? The answer can be summed up in one word: lawsuits. Although women offered VBAC were counseled about the small risk of uterine rupture (opening of the uterine scar during labor) and the attendant risk that the baby might die in the event of a rupture. Nonetheless, when a baby died after a uterine rupture, many mothers sued, and claimed that they had not "understood" the risks, even though those risks were clearly explained. Juries were moved by these emotional appeals, and large judgments were paid out.

The American College of Obstetricians (ACOG) stepped into the breach and, attempting to make things better, made them far worse. Unfortunately, the ACOG guidelines were so strict (unreasonably strict in the eyes of most obstetricians) that most obstetricians could not meet them. ACOG mandated that VBAC should only be attempted when both an anesthesiologist and obstetrician were present so that anyone who experienced a uterine rupture could be treated immediately. Most medium sized and small hospitals cannot afford to have an anesthesiologist in the hospital around the clock. Most obstetricians cannot afford to sit for hours while a patient labors. Therefore, many hospitals and anesthesiologists stopped offering VBAC.

The latest NIH panel reviewed the scientific literature and confirmed their earlier stance. VBAC should be offered to eligible women because the chance of success is high and the risk of complications is low. Furthermore, the conference report urged ACOG to re-evaluate their VBAC guidelines, presumably to eliminate the need for continuous presence of both anesthesiologist and obstetricians. In addition, the panel recommended that policy makers review the medico-legal strictures on VBAC, since liability concerns are driving the restriction of VBACs.

So doctors, patients and NIH are in agreement that VBAC should be offered to many more women. Too bad the lawyers don't agree, since they seem to be in charge of making the decision, and they recommend C-section.

Great Neck Obstetrics and Gynecology offers our patients the option to attempt Vaginal Birth After Cesarean if they are appropriate candidates for VBAC. We are able to offer 24 hour anesthesiology and OR availability at North Shore University Hospital in Manhasset, in the unlikely event of a uterine rupture in labor. Hopefully with a national committment to continue to investigate this health issue and with continued efforts to educate patients, doctors and hospitals alike, we may be able encourage doctors and hospitals to offer patients this option,and begin to see an appropriate increase in VBAC rates in our country.

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Pregnancy Weight Gain Increases Diabetes Risk

Pregnancy Weight Gain Weight gain during pregnancy, especially in the first trimester, could increase women's risk of developing diabetes later in their pregnancy, according to a new study. The study by the Kaiser Permanente Division of Research appears online in the current issue of Obstetrics and Gynecology.

The three-year study of 1,145 pregnant women from an ethnically diverse population found that women who gained more weight than is recommended by the Institute of Medicine had a 50 per cent increased risk of developing gestational diabetes mellitus.

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Retracting A Medical Journal's Autism Study

Autism Study Last week, the highly regarded medical journal, The Lancet, retracted a much debated 1998 study that had linked the measles, mumps and rubella vaccine to autism.

The study was retracted after concerns about ethical breaches by one of the study authors. In addition, 10 of the 13 co-authors have disavowed the study's conclusions. "We fully retract this paper from the published record," The Lancet editors said in a statement.

But the damage has been done. The paper has fueled fears about the risks of childhood vaccinations and autism, particularly the M.M.R. vaccine, despite numerous studies showing no link.

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