Tamoxifen (an estrogen blocker) is currently the most prescribed drug to fight breast cancer recurrence.  However up to 1/3 of women do not respond to Tamoxifen.  The reasons for this are not completely known as of this post but are believed to lie in a gene -FGFR1.

Researchers are now working [...]]]> Source:  BBC Health; Journal Cancer Research

Tamoxifen (an estrogen blocker) is currently the most prescribed drug to fight breast cancer recurrence.  However up to 1/3 of women do not respond to Tamoxifen.  The reasons for this are not completely known as of this post but are believed to lie in a gene -FGFR1.

Researchers are now working on methods to “switch off” the FGFR1 gene so that the therapeutic effects of Tamoxifen may be realized in greater numbers.  1 out of every 10 breast cancer survivors have the FGFR1 gene.  There are currently a number of drugs which are known to inhibit FGFR1.

The stage is now set for clinical trials.  If the laboratory evidence is repeatable in the real world this could mean less recurrence of breast cancer for more women.  Breast cancer is the most common disease causing death for women in the US and in the UK.

~Posted by D.M. Schwadron, Esquire

Must be the wooden shoes.  Researchers from Vrije University (between Amstelveenseweg and De Boelelaan Streets in Amsterdam –Look it it up if you don’t believe me), have studied the development of eggs in over 500 Dutch women to determine why women over age 35 have twins more frequently than [...]]]> Source:  Journal of Human Reproduction;  BBC Health

Must be the wooden shoes.  Researchers from Vrije University (between Amstelveenseweg and De Boelelaan Streets in Amsterdam –Look it it up if you don’t believe me), have studied the development of eggs in over 500 Dutch women to determine why women over age 35 have twins more frequently than women under age 30.

Quick medical lesson:  Twins occur when 1 fertilized egg divides into 2 infants (identical) or when 2 eggs become fertilized instead of just 1 (non-indentical).  3/4 of all twin pregnancies are non-identical.  A hormone called FSH (Follicle Stimulating Hormone) starts the process of egg production in the ovaries.

Back to the study.  Of the 500 women, 105 developed multiple follicles.  Of those, 55 were found in women over age 35 while just 5 were to women under age 30. Why?  Well, it appears that prior to menopause women overcompensate (that’s NOT a value judgment) and produce higher levels of FSH.   Typically this will not result in multiples only due to the relative age of the eggs.  However, a number of women produce viable eggs late into their reproductive lives making this phenomenon possible.

So while advanced maternal age is more commonly associated with infertility, it is also associated with high fertility. The more you know…

~Posted by D.M. Schwadron, Esquire

I know, I know…Let them sleep on their backs…No wait, only on their stomachs…No wait, on their backs but no pillows…or blankets…No smoking…No pets…Never in bed with you…

Perhaps it’s no wonder why the Amercian Academy of Pediatrics is constantly revising guidelines [...]]]> Source:  U.S. National Institutes of Health; Journal of the American Medical Association, February 3, 2010

I know, I know…Let them sleep on their backs…No wait, only on their stomachs…No wait, on their backs but no pillows…or blankets…No smoking…No pets…Never in bed with you…

Perhaps it’s no wonder why the Amercian Academy of Pediatrics is constantly revising guidelines for infant sleep.  There is a wealth of information seemingly linking SIDS (Sudden Infant Death Syndrome) with, well, everything.  The latest?  Serotonin. Huh?  Okay, back to biochemistry class we go.  Serotonin is a neurotransmitter, don’t worry about what kind, it’s presence or absence in sufficient quantities is  broadly responsible for the regulation of mood, appetite, sleep, muscle contraction, and some cognitive functions including memory and learning. Modulation of serotonin at synapses is thought to be a major action of several classes of pharmacological antidepressants.  As an interesting aside (well interesting to me anyway) certain foods, carbohydrates mostly -pasta, chips also seem to have a serotonin level response.

So why all the chemistry talk? Because researchers studying the brains of infants who have died from SIDS have found that they were producing low levels of serotonin. No, they weren’t depressed, well not emotionally anyway.  However, to the extent that serotonin may be responsible for breathing they may be onto something.  How much lower?  26% lower according to this study. Measures of an enzyme required to manufacture serotonin (tryptophan hydroxylase for those of you playing the home game) were also 22% lower in the brains of the SIDS death infants studied.

Yes, they are still currently recommending the whole back sleeping thing. For a complete list of sleeping guidelines see http://www.nicdh.nih.gov/sids/ or speak with your pediatrician or obstetrician.

~Posted by D.M. Schwadron, Esquire

Admittedly it was a small, focused study of 36 newborns, 17 of whose mothers smoked during pregnancy.  It is, however, alarming and instructive.  Babies that had been exposed to cigarette smoke in utero (While in Mommy’s belly) demonstrated abnormal heart rates and blood pressures.

But that’s not all. . .rather than [...]]]> Source:  BBC Health; Karolinska Institute (Sweeden)

Admittedly it was a small, focused study of 36 newborns, 17 of whose mothers smoked during pregnancy.  It is, however, alarming and instructive.  Babies that had been exposed to cigarette smoke in utero (While in Mommy’s belly) demonstrated abnormal heart rates and blood pressures.

But that’s not all. . .rather than dissipate with age, the abnormalities appear to have worsened from one week to age one. According to lead researcher, Dr. Gary Cohen, “Babies of smokers have evidence of persistent problems in blood pressure regulation that start at birth and get worse over time” and “[E]arly life exposure to tobacco can lead to long lasting reprogramming of the infant blood pressure control mechanism.”

And Dr. Cohen adds, this might be the mechanism which explains why infants of smokers are at increased risk for SIDS (Sudden Infant Death Syndrome) or “Cot death” as it is known in the UK.

~Posted by D.M. Schwadron, Esquire

Remember that post about the safety of prescription medications for pregnant women? http://www.medicalmalpracticelawyerblogphiladelphia.com/?p=528

Well, researchers in Washington (State not the Nation’s capital) have found in a study of 3,000 women, those taking selective serotonin reuptake inhibitors (SSRIs) into their 2nd and 3rd trimesters had an increased [...]]]> Source: Reuters Health; American Journal of Obstetrics & Gynecology, December 2009

Remember that post about the safety of prescription medications for pregnant women? http://www.medicalmalpracticelawyerblogphiladelphia.com/?p=528

Well, researchers in Washington (State not the Nation’s capital) have found in a study of 3,000 women, those taking selective serotonin reuptake inhibitors (SSRIs) into their 2nd and 3rd trimesters had an increased risk (14%) of giving birth prematurely.

Medications such as Zoloft, Paxil and Prozac were felt to have no appreciable impact during the 1st trimester, however benzodiazepines, such as Ativan and Xanax were linked with preterm labor, low birth weight, respiratory distress and low Apgar Scores.

Among the women in the study who did not take any such medications, only 9% gave birth prematurely as opposed to nearly half of the women taking benzodiazepines.

One might very well question why, with the prevalence of such prescriptions, studies such as this were not published earlier.

~Posted by D.M. Schwadron, Esquire.

According to the CDC, some 3,000 pregnancies a year are ffected by spina bifida or anencephaly (, neural tube defects caused by the incomplete development of the brain and spinal cord).  Studies have shown that women taking 400 mcg of folic acid daily both before and during pregnancy [...]]]> Source: U.S. Centers for Disease Control & Prevention

According to the CDC, some 3,000 pregnancies a year are ffected by spina bifida or anencephaly (, neural tube defects caused by the incomplete development of the brain and spinal cord).  Studies have shown that women taking 400 mcg of folic acid daily both before and during pregnancy may reduce the risk of neural tube defects by up to 70%.

Is it safe? Folic acid is a type of B vitamin.  It is largely recognized as safe.

When should you take folic acid? Neural tube and spinal defects occur in the first few weeks of pregnancy, often before a woman finds out that she is pregnant.  All women of child-bearing age should get in the habit of taking folic acid daily.  This is true even if they are not planning to get pregnant.

Where do you get folic acid? You can get your vitamin with folic acid with or without a prescription in one of several ways.  You can take a multivitamin or a small, single supplement of folic acid.  Unless your doctor suggests a special type, you do not need to choose among vitamins for women or active people, or even to go with a low carbohydrate diet. A basic multivitamin meets the needs of most women.

Another way to get enough is to eat a serving of breakfast cereal every day that has been enriched with 100% of the daily value of folic acid. Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.

Safe, Effective and readily obtainable.

~Posted by David Marc Schwadron, Esquire

The vast majority of women who are pregnant are also taking at least one prescription drug. In our modern, hectic and stressful society, antidepressant and anti-anxiety medications are among them.  But are they really safe?

The answer is we really don’t exactly know…exactly. There are [...]]]> Source:  US Dpt. of Health & Human Services; www.womens.health.gov; Wall Street Journal

The vast majority of women who are pregnant are also taking at least one prescription drug. In our modern, hectic and stressful society, antidepressant and anti-anxiety medications are among them.  But are they really safe?

The answer is we really don’t exactly know…exactly. There are studies which show minimal issues but there is surprisingly little medical evidence to support the notion that the majority of common prescriptions are truly “safe” for your baby.  The following classifications demonstrate how much we don’t know.  The FDA is currently funding a study to evaluate about one million births between 2001 and 2007, the time when a number of these medications became quite popular.  Ask questions of your doctor.  lots of questions.  The good ones will answer you.

~Posted by David Marc Schwadron, Esquire

The US Preventative Services Task Force has released the latest (11/2009) recommendations for Breast Cancer Screening.  Were I a woman or performing breast self-examination (BSE) on, well myself, I’d be confused.

The Task Force has un-recommended (hey if “un-friend” is now a word, this can’t be [...]]]> Source: US Department of Health and Human Services November 2009 Release

The US Preventative Services Task Force has released the latest (11/2009) recommendations for Breast Cancer Screening.  Were I a woman or performing breast self-examination (BSE) on, well myself, I’d be confused.

The Task Force has un-recommended (hey if “un-friend” is now a word, this can’t be far behind) screening mammography for women under 50. In fact, they specifically recommend against routine screening mammography in women ages 40-49.

This represents a return to the previous recommendation for biennial screening mammograms for women ages 50-74.  The Task Force saw no benefit to routine screening for women under 50 or 75 and over.

The Task Force additionally recommends against teaching patients to perform breast self- examination, a position which runs contrary to that taken by this pro BSE blogger. See http://www.medicalmalpracticelawyerblogphiladelphia.com/?p=376 It is the anecdotal and lay experience of the author that many women under age 50 discover masses or lumps on breast self-examination and that this discovery directly leads to their diagnosis.

That aside, anticipate the pro-mammography lobby to push for a formal adoption/return to the 40 and over recommendation for various reasons both medical and economic.

~Posted by David Marc Schwadron, Esquire

A recently published study on Hypergylcemia (hyper = too much) and it’s effect upon pregnant women suggests (because we never really know for sure) that glucose levels at the High-normal end during the first trimester increase the risk of poor pregnancy outcomes including gestational diabetes.

The current recommended screening for [...]]]> Source: Diabetes Care, 2009; 32: 1639-1643.

A recently published study on Hypergylcemia (hyper = too much) and it’s effect upon pregnant women suggests (because we never really know for sure) that glucose levels at the High-normal end during the first trimester increase the risk of poor pregnancy outcomes including gestational diabetes.

The current recommended screening for gestational diabetes is at the start of the third trimester. For those of you struggling with math, that’s two trimesters later and since we are talking about trimesters, it’s toward the end of pregnancy.  Intuitively it seems to be a good idea to test women earlier then later so that any complications of pregnancy may be avoided.  If these results prove reliable then perhaps new recommendations are in order.

Yes, I’m aware that the fasting test is miserable, second only to that test where you have to basically drink a gallon of horribly flavored sugar-water.  Oh, and that whole weighted speculum thing.  I’m only responsible for the blog posts.

Posted by David Marc Schwadron, Esquire

_ You or a loved one were significantly injured from a surgical error or complication of surgery

_ You or a loved one were significantly injured from improper medical care or treatment

_ You or a loved one were diagnosed with breast, ovarian, prostate or other cancer after a year [...]]]> You MAY have a medical malpractice case if:

_ You or a loved one were significantly injured from a surgical error or complication of surgery

_ You or a loved one were significantly injured from improper medical care or treatment

_ You or a loved one were diagnosed with breast, ovarian, prostate or other cancer after a year or more of having symptoms

_ You or a loved one experienced stroke, heart attack or pulmonary embolism after being discharged from a hospital ER

_ You or a loved one contracted a serious infection while in a hospital

_ You or a loved one have bed sores or broken bones from a fall during a nursing home stay

_ You or a loved one experienced significant injury while being treated at a Veterans’ Hospital

_ You or a loved one were prescribed the wrong medication or too much medication

_ Your baby experienced hypoxia, birth asphyxia or brain injury following delivery due to a delay in delivery

_ Your baby experienced shoulder dystocia or nerve injury to the shoulder, arm and hand following delivery

_ You or a loved one are having a hard time getting answers from your doctor or hospital

_You or a loved one are having problems getting your medical records from your doctor or hospital

_ The records from your doctor or hospital do not accurately reflect the care you received

If you have checked Yes to any of these questions and (IN PA and NJ) the medical treatment at issue occurred within the past 2 years, you MAY have a medical malpractice case.  The Lewis Law Firm, PC will provide you with a free initial consultation to determine whether you have a medical malpractice case.

Complications, including significant injury or death, following medical treatment create confusion in addition to pain and loss.  You may have “a gut feeling” that something went wrong.  You may be too uncertain or even embarrassed about questioning medical care to consult with a lawyer.

The above is a quick check list of “red flags” which might indicate that your “gut feeling” is correct.  Obviously one can never determine from a checklist whether you actually have a medical malpractice case.  But these are certainly some good questions to start with.

Posted by David Marc Schwadron, Esquire