Category: Pre- and Post-Natal

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Zapping Zika

 
zapping.zika.9.25.16

Recently, the National Center for Advancing Translational Sciences (NCATS), a subsidiary of the National Institutes of Health (NIH), announced exciting news in the fight against Zika.  Not only have they made progress regarding potential medication, but they have also begun researching a possible vaccine to enable immunity against the devastating disease.

 

The Zika virus, whose name is derived from the Uganda Zika forest (where the virus was first identified in 1947), is spread by diurnal Aedes mosquitos.  Prior to 2007, the virus was mostly contained within limited parts of Africa and Asia.  However, the virus spread east between 2007 and 2016 across the Pacific Ocean to Latin America and beyond.  To date, Zika has been reported in over sixty countries.  Adults who are infected with the virus may develop a fever which can be alleviated with acetaminophen.  Furthermore, Zika can result in the development of Guillian-Barre Syndrome or other neurological dysfunction in adults.

 

Additionally, a truly dangerous feature of the Zika virus is that it frequently attacks the brain cells of the developing fetus in utero.  This may lead to fetal microcephaly, small sized head due to an underdeveloped brain, or brain malformations.

 

Fortunately, researchers at John Hopkins University and Florida State University have been developing a medication to treat the virus.  The compound under investigation contains both emricasan (a drug being explored for its potential benefit against certain liver diseases) and niclosamide (an FDA-approved medication used to treat worm infections).  Finally, several cyclin-dependent kinase (CDK) inhibitors were associated with decreased brain cell death in the NCATS research.  (CDK inhibitors interfere with cellular reproduction, and this class of drugs is often used to treat cancer and prevent cancer cells from spreading.) It is unclear whether or not the medication is safe for usage during pregnancy.  Further research is warranted to determine safety for expectant mothers.

 

Furthermore, the NIH released on August 3, 2016 that they have initiated clinical trials with a potential Zika vaccine.  The National Institute of Allergy and Infectious Diseases (NIAID), a different branch of the NIH, has gathered approximately eighty volunteers (aged 18-35) who are being followed at three different study centers.  Researchers are analyzing the immune system’s response to the proposed vaccine.  However, the clinical trial is merely in the early stages, so results will probably be unavailable for some time yet.

Fortunately, advances in potential Zika prevention and treatment are underway.  Until then, it is wise to plan vacations accordingly, especially if you are attempting to become pregnant in the near future.  Please refer to this information released by the Centers for Disease Control and Prevention for more detail.

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Forty are the Weeks Before a Baby’s Born

Pregnant woman caressing her belly over gray background
How long is pregnancy expected to last?  According a popular Jewish song I grew up with at the Passover Seder, “Nine are the months before a baby’s born.”  And nine months times four weeks per month = 36 weeks of pregnancy, right?

Wrong.  As I focused my studies on high level scientific subjects, all of a sudden women seemed to be pregnant for an entire four additional weeks.  Apparently, pregnancy is actually forty weeks.

In a fascinating and entertaining recent article, (August 1, 2016, link to article) Dr. Chavi Eve Karkowsky, a high-risk pregnancy specialist, encourages society to count pregnancy in “weeks” instead of “months” for several reasons.  She explains that the estimated due date (EDD) which doctors often share with expectant mothers is 280 days (or nine months and seven days) after the first day of the last menses.  Conception is estimated at approximately two weeks after this date (i.e. 38 weeks before the EDD).  In case a woman forgets when the first day of her last menses occurred, ultrasound can also be used to determine the EDD.

According to Karkowsky, months are an inappropriate measure of pregnancy. The increment of time is simply too large.  It would be like trying to measure spices with a cup while cooking!  Weeks more accurately reflect the subtle developments and changes that occur within the growing fetus.  Pregnancy related tests and fetal monitoring examinations must be performed throughout the gestation, and measuring pregnancy in terms of weeks enables clinicians to perform these tests at the most appropriate time, with greater precision.

Furthermore, Karkowsky promotes speaking about weeks instead on months because pregnancy is actually longer than nine months.  True, if all months were non-leap year Februaries (i.e. 28 days long), then perhaps we would have what to discuss.  However, as you may remember from a popular childhood adage, every other calendar month is 30 or 31 days.  This means that technically speaking, each month is approximately 4.3 weeks, which would translate into 40 weeks totaling slightly longer than nine months.  Mentally calculating weeks into months will result in mistakenly assuming that one’s pregnancy is shorter than it actually is.  By the time most women arrive at the nine month mark and are ready to roll, the last thing they want to hear is “Oops, just kidding.  On second thought, this pregnancy is actually going to last an additional third of a month longer.”  From the perspective of setting realistic expectations “weeks” is better than “months.”

If you are currently counting the weeks (or months) of your pregnancy, congratulations!  Hopefully you are feeling great and managing well despite the summer heat.  If, however, you are experiencing musculoskeletal pregnancy related changes or pain, Revitalize Physical Therapy would love to help. Pre and post-partum related changes are among our specialties, and it would be an honor to ease you into motherhood as smoothly as possible.