David Warmflash
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Articles by David Warmflash
Menopause: Three Things You May Not Know
As a clinician, you probably understand the physiology and pathophysiology of menopause quite well. Some, possibly many, of your patients may require active management of menopause: evaluating symptoms, preventive health screenings, monitoring their bone health and cardiovascular risks, lifestyle counseling. But here are three things you may not know about the history of humans dealing with menopause and medicine's efforts to understand the process. 1.
Cataract Surgery: 4 Things You Might Not Know
Cataract removal is the most common surgical procedure in the United States, with roughly 3.8 million of the operations performed each year. Routine, quick, and highly successful, patients are in and out of the office in hours, bringing home millimeter-scale incisions and vastly improved eyesight. Yet you may know little of its history, stretching back millennia and punctuated with breakthroughs, some of them happening earlier than you might expect.
Schistosomiasis: Four Things You May Not Know
The World Health Organization recently highlighted schistosomiasis among a handful of parasitic diseases posing a major concern for the next decade. While you’re far more likely to encounter this condition on your board recertification than in your practice, it has maintained a consistent second place to malaria as the world’s most devastating parasitic disease. It also has a pretty interesting history.
Hepatitis B Vaccine: 4 Things You May Not Know
The CDC Advisory Committee on Immunization Practices recently ended the federal recommendation for a universal birth dose of the hepatitis B vaccine. If you’re following this issue, you may also know Robert F. Kennedy (RFK) Jr, Secretary of the Department of Health and Human Services, has been planning to fund a study in the West African country Guinea-Bissau of the birth dose, a trial that has drawn criticism on ethical grounds.
Vitamina D: quatro coisas que você talvez não saiba
Como médico, você provavelmente conhece bem a fisiopatologia da deficiência de vitamina D. Mas eis aqui quatro coisas que você talvez não saiba sobre o papel em constante evolução desse hormônio no tratamento e na prevenção de doenças. O papel do raquitismo Você certamente sabe que a deficiência de vitamina D pode causar osteopenia e osteoporose, bem como osteomalácia.
Vitamin D: 4 Things You May Not Know
As a clinician, you probably understand the pathophysiology of vitamin D deficiency well. But here are four things you may not know about the evolving role of this hormone in the treatment and prevention of disease. The Role of Rickets You certainly know vitamin D deficiency can lead to osteopenia and osteoporosis, as well as osteomalacia.
Vitamina D: breve repaso histórico
Como profesional médico probablemente comprenda bien la fisiopatología de la deficiencia de vitamina D. Pero aquí hay cuatro cosas que quizá no sepa sobre el papel cambiante de esta hormona en el tratamiento y la prevención de enfermedades. El papel del raquitismo La deficiencia de vitamina D puede provocar osteopenia y osteoporosis, así como osteomalacia.
Marrying your cousin: Might your children gave there any evolutionary benefits
“It’s All Relative in West Virginia” read one. “West Virginia: No Lifeguard at the Gene Pool” read another. These incest-themed slogans, which appeared on Abercrombie & Fitch T-shirts, caused quite an uproar back in 2004. The level of outrage these shirts generated is a reminder that incestuous relations are a third rail of genetics research. Genetic counselors typically warn against close-cousin procreation, and US laws partly reflect this.
Ectogenesis: How artificial placentas could aid premature babies, upend entrenched abortion views
It’s called an artificial placenta, it’s not science fiction anymore, and it’s a major technological milestone along the path to ectogenesis — development from egg to full-term infant outside the mother’s body. Ectogenesis would require a complete artificial womb, and the timeline for achieving that is hard to plot. But the artificial placenta could be seen much sooner. That’s exciting for some people, frightening for others.
The great martian debate: Did we find life on Mars?
This year marks 100 years since the births of two pioneers in the search for life on Mars. Joan Oró and Gilbert V. Levin were part of NASA’s Project Viking, which delivered twin spacecraft to Mars in 1976. Each consisted of an orbiter and a lander probe, carrying a suite of scientific instruments designed to look for life on Mars. While both Oró and Levin worked directly on instruments for Viking, they had very different interpretations of the mission’s scientific findings.
Better than dialysis? Artificial kidney could be the future
Nearly 90,000 patients in the United States are waiting for a lifesaving kidney transplant, yet only about 25,000 kidney transplants were performed last year. Thousands die each year while they wait. Others are not suitable transplant candidates. Half a million people are on dialysis, the only transplant alternative for those with kidney failure. This greatly impacts their work, relationships, and quality of life.
Better Than Dialysis? Artificial Kidney Could Be the Future
close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Nearly 90,000 patients in the United States are waiting for a lifesaving kidney transplant, yet only about 25,000 kidney transplants were performed last year. Thousands die each year while they wait. Others are not suitable transplant candidates.
New tech promises better blood oxygen readings on dark skin
Researchers in Texas are developing a “green light” technology they hope will solve a crucial problem highlighted by the pandemic: the limits of pulse oximeters in patients with darker skin. A recent study adds weight to earlier findings that their device works. “It is a new, first-in-class technology,” said Sanjay Gokhale, MD, the bioengineer who is leading this research at the University of Texas at Arlington.
Oximetria: luz verde deve substituir a vermelha?
close Tem certeza que quer sair? Sair Cancelar Pesquisadores estadunidenses estão desenvolvendo uma tecnologia com "luz verde" que esperam resolver um problema crucial evidenciado pela pandemia: os limites dos oxímetros para os pacientes com pele mais escura. Um estudo recente acrescenta valor a evidências anteriores de que o novo dispositivo funciona.
Pulse-Ox: Green Light May Work Better Than Red on Dark Skin
Researchers in Texas are developing a "green light" technology they hope will solve a crucial problem highlighted by the pandemic: the limits of pulse oximeters in patients with darker skin. A recent study adds weight to earlier findings that their device works. "It is a new, first-in-class technology," said Sanjay Gokhale, MD, the bioengineer who is leading this research at the University of Texas at Arlington.
New Tech Promises Better Blood Oxygen Readings on Dark Skin
July 26, 2023 -- Researchers in Texas are developing a “green light” technology they hope will solve a crucial problem highlighted by the pandemic: the limits of pulse oximeters in patients with darker skin. A recent study adds weight to earlier findings that their device works. “It is a new, first-in-class technology,” said Sanjay Gokhale, MD, the bioengineer who is leading this research at the University of Texas at Arlington.
Will science ever be able to create an artificial womb?
A re you interested in having children, but turned off by the whole pregnancy thing? Well, there may be an option available in the not-too-distant future. The artificial womb–or at least the ability to create one–is inching its way toward us. The big question is whether or not society is ready for it.
Sheehan Syndrome: What You Need to Know
Recently, we discussed how postpartum hemorrhage, bleeding that occurs after childbirth as one of the most common obstetric emergencies. Resulting from a variety of causes, including uterine atony (failure of the uterus to contract after delivery), lacerations in the genital tract, and retained placental fragments, postpartum hemorrhage is more likely in the presence of certain risk factors, such as prolonged labor, instrumental delivery, uterine dysfunction, and previous postpartum hemorrhage.
New Tech for Gene Therapy Could Advance Longevity
By David Warmflash Gene therapy has come a long way since it was first used on humans 33 years ago. Since 2000, incremental progress has expanded the use of ex vivo gene therapy (where cells are harvested from a person, genetically modified, and then infused back into the person's bloodstream). And in vivo gene therapy, which involves injecting genes directly into the body, has proven safe and effective in a number of clinical trials.
Postpartum Anemia: A Complication of Labor and Delivery
Doctors diagnose postpartum anemia when the concentration of hemoglobin in the mother’s blood drops below 100 g/L (10 g/dL) in the postpartum period, the period after delivery. Anemia is common after delivery on account of substantial blood loss. This is because most women giving birth lose some blood during delivery of the baby. This blood loss comes when many pregnant women are already hovering on the border of anemia.
Congenital Syphilis Rose 900 Percent in Mississippi
Recently, health officials have reported that the incidence of congenital syphilis in the US state of Mississippi has risen by more than 900 percent over five years. This constitutes a major public health crisis, according to health experts, but you probably don’t need a health expert to let you know this. Syphilis is a sexually transmitted disease and one of the notorious TORCH infections.
Causes, symptoms and treatments
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Umbilical Cord Prolapse: What You Need to Know
Umbilical cord prolapse is a condition in which the umbilical cord descends beneath the presenting part of the fetus. This means that the cord is below the head in a normal cephalic (head down) presentation and passes through the cervix into the vagina after rupture of the fetal membranes (water breaks). This compresses the umbilical cord, causing fetal hypoxia, meaning lack of oxygen to the fetus.
Causes, symptoms and treatment
Microsoft Cares About Your Privacy Microsoft and our third-party vendors use cookies to store and access information such as unique IDs to deliver, maintain and improve our services and ads. If you agree, MSN and Microsoft Bing will personalise the content and ads that you see. You can select ‘I Accept’ to consent to these uses or click on ‘Manage preferences’ to review your options and exercise your right to object to Legitimate Interest where used.
Does It Still Make Sense to Mask up in Pregnancy to Protect You and Your Fetus from Viral Disease?
Throughout the three-year course of the COVID-19 pandemic, those of us who contribute to The Pulse have been committed to following the science. This can mean many things. When no data, or very few data, are available, following the science can mean acting based on a working hypothesis and following recommendations of experts, based on educated guesses and proposed mechanisms that have a basis in what we know from experience with related issues in science and medicine.
What Is Failure to Progress?
Failure to progress is a situation in which labor is not advancing enough for a safe labor and delivery. The situation increases the risk to the fetus and to the mother, and it’s more likely to occur in women who are giving birth for the first time compared with those who have previously given birth. The first stage of labor has three phases. The first phase is when the cervix dilates (opens) up to 3 centimeters, which should happen at a rate of 0.5 cm per hour.
50th Anniversary of Roe versus Wade: Historical Perspective
This past January 22, 2023, the United States looked back on 50 years since the Supreme Court of the United States (SCOTUS) issued the famous Roe versus Wade decision. Issued in 1973, the decision established the right for a woman to terminate her pregnancy based on what legal experts call substantive due process.
HELLP Syndrome: What You Need to Know
Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic HELLP Syndrome, go here. These expert reports are free of charge and can be saved and shared. __________________________________ HELLP syndrome is a rare complication of pregnancy.
Stretching human life span to 200 years? Implications of bowhead whale study
T here’s no one gene that can extend the human lifespan dramatically, but current science suggest that entire sets of genes could be a big part of the answer. Pat of the answer to the mystery of aging might be found in the vast oceans of our world. Whales have been on this planet millions of years longer than we have.
Pulmonary Embolism and Pregnancy: What You Need to Know
Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Pulmonary Embolism, go here. These expert reports are free of charge and can be saved and shared.
Deadly Caissons, Toxic Watch Faces and More Medical Mysteries
close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel Case reports are the low-hanging fruit in the orchard of medical publishing: easy papers to write, padding for the CV. But not always. Sometimes, these cases represent the earliest awareness of larger issues and lead to major changes in patient care and public health.
Cesarean Birth Can Sometimes Cause Rare Complications
One of my favorite TV shows, but whose first season should not be viewed prior to giving birth, is 2014-2015 Cinemax series The Knick. Set in New York City in the years 1900-1901, this was a period medical drama focusing especially on the formative years of modern surgery. The very first episode begins with a cesarean section, attempted on account of placenta previa (the placenta is blocking the cervix), making vaginal delivery potentially fatal.
Reproductive Care and Abortion in the US Virgin Islands
We are approaching the end of our reproductive tour of the United States, headed today for a US territory, the US Virgin Islands. Here on The Pulse, we have been going state by state, region by region, looking at reproductive law, especially as it relates to abortion, because of the Supreme Court of the United States (SCOTUS) decision last June.
The Pregnancy Booster Dilemma Part 2: How to Decide About the Next Dose
In part 1 of this series, we explored passive immunity more deeply than we have done in the past. We did this, so that we could now take a deep dive into the issue of a fourth dose of vaccine against SARS-CoV2 (the virus that causes COVID-19).
The Pregnancy Booster Dilemma Part 1: How Vaccines Provide Your Fetus with Passive Immunity
In this two part series, we will discuss passive immunity and how this creates a dilemma if you are pregnant, healthy, and already have received several vaccine doses against SARS-CoV2 (the virus that causes COVID-19). In this first part, I’ll provide some background, which will set us up to talk about the booster dilemma. In general medicine, you have heard about it in the context of COVID-19 and monoclonal antibodies (mAbs).
Texas: Abortion and Reproductive Care in the Lone Star State
Here on The Pulse, we are doing this tour of the United States to explore the differences in reproductive law from state-to-state, as it applies to abortion, pregnancy care, and related matters. This whole thing started back in June, 2022, when the Supreme Court of the United States (SCOTUS) decided on the Dobbs versus Jackson Women’s Health Organization case on abortion. The Dobbs case involved a Mississippi law prohibiting abortion after 15 weeks of pregnancy.
Pacific Territories: Reproductive Care and Abortion in the Northern Mariana Islands, Guam, and American Samoa
We are close to the end of our journey through the United States, looking at the laws governing abortion and related matters. Here on The Pulse, we have been going state by state, and also through US territories, looking at reproductive law, because of the Supreme Court of the United States (SCOTUS) decision last June. This decision was on Dobbs versus Jackson Women’s Health Organization, an abortion case concerning a Mississippi law prohibiting abortion after 15 weeks of pregnancy.
Update on mRNA Vaccines: Slight Menstrual Disruptions Still Do Not Translate to Fertility Problems
Update on mRNA Vaccines: Slight Menstrual Disruptions Still Do Not Translate to Fertility Problems They’re at it again. Anti-vaccine activists once again are spreading misinformation aimed to promote fear of mRNA vaccines among women of reproductive age. A quintessential example is recent tweet, posted February 2, 2023, by Rep. Marjorie Taylor Greene, who claims not to have been vaccinated against SARS-CoV2 (the virus that causes COVID-19).
Maternal Sepsis: Medicine Used to Call It Childbirth Fever
Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Sepsis, go here. These expert reports are free of charge and can be saved and shared. __________________________________ Sepsis is a condition in which the body reacts to an infection in such an extreme way that it threatens the life of the person and will very likely lead to death if doctors do not intervene aggressively.
Louisiana: Abortion and Reproductive Care in the Bayou State
We’re on a reproductive tour of the United States that takes us today to Louisiana, also known as the Bayou State. As you know by now, if you have been reading my posts here on The Pulse, we are doing this tour because of what the Supreme Court of the United States (SCOTUS) did last June, regarding the Dobbs versus Jackson Women’s Health Organization case on abortion.
SARS-CoV2 Virus May Cause Fetal and Placental Abnormalities, Recent Study Suggests
Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Coronavirus (COVID-19), go here. These expert reports are free of charge and can be saved and shared.
Ischemic Stroke and Pregnancy: Should You Worry About a Recent Report Related to the Pfizer-BioNTech Vaccine?
Last month, there was a preprint report of a possible safety signal on the Pfizer-BioNTech vaccine against SARS-CoV2 (the virus that causes COVID-19). As a preprint, the paper had not been peer reviewed (reviewed and criticized by other researchers with expertise in the area).
Abortion and Reproductive Care in the Dakotas
As you know by now, if you have been reading my posts here on The Pulse, we are exploring the United States, state by state, region by region, because of what the Supreme Court of the United States (SCOTUS) did last June. On the Dobbs versus Jackson Women’s Health Organization case on abortion, the SCOTUS upheld a Mississippi law prohibiting abortion after 15 weeks of pregnancy. This means 15 weeks counting from the first day of bleeding of the last menstrual period.
Experimental Male Oral Contraceptive Prevents Pregnancy in Mice: Human Trials Could be Around the Corner
In 1960, the US Food and Drug Administration (FDA) approved the first formulation of oral contraceptive for women, consisting of synthetic estrogen and progestin components. This was a huge development, carrying major societal consequences. In fact, historians of the mid 20th century have sometimes suggested that advent of “the pill” —which, early on, referred to a handful of different oral contraceptive regimens and now consists of numerous— carried major societal consequences.
Recent Vaccine Advisor Meeting: Relevance for Pregnancy
On January 26, 2023, the US Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee met to discuss current issues related to immunization against SARS-CoV2, the virus that causes COVID-19. Prominent among discussions was the topic of mRNA vaccine boosters. On August 31, 2022, the FDA issued emergency use authorization (EUA) for new booster shots of Pfizer-BioNTech and Moderna.
Why Does Your Blood Clot More Easily During Pregnancy?
Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Blood Clots, go here. These expert reports are free of charge and can be saved and shared. ______________________________________________________________________________ Here on The Pulse, we have explored how various aspects of the body change during pregnancy.
California Votes in Constitutional Guarantee for Abortion and Contraception Access
Here on The Pulse, we have been exploring the United States, state by state, region by region, because of the Supreme Court of the United States (SCOTUS) decision last June. This was a decision on the Dobbs versus Jackson Women’s Health Organization case on abortion. The SCOTUS upheld a Mississippi law prohibiting abortion after 15 weeks of pregnancy. This means 15 weeks counting from the first day of bleeding of the last menstrual period.
Three wild technologies about to change health care
When I was a child, I watched syndicated episodes of the original “Star Trek.” I was dazzled by the space travel, sure, but also the medical technology. A handheld “tricorder” detected diseases, while an intramuscular injector (“hypospray”) could treat them. Sickbay “biobeds” came with real-time health monitors that looked futuristic at the time but seem primitive today. Such visions inspired a lot of us kids to pursue science.
COVID-19 Vaccine Timing: What’s the Optimal Point in Pregnancy for Passively Immunizing Your Fetus with Maternal IgG?
Here on The Pulse, we have devoted a good amount of time discussing passive immunity. In the context of pregnancy and neonatology, passive immunity is the phenomenon in which the perinate —the fetus prior to birth, the neonate after birth— receives protection against disease-causing agents by way of maternal antibodies. This means that getting vaccinated while you’re pregnant is good for you and for your baby. Generally, only ‘live attenuated’ vaccines are contraindicated in pregnancy.
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