The Tragedy of Ebola in Pregnancy

In Blog, Gynecology, Infections by Dr. Gary Goldman

The tragedy of Ebola in West Africa is particularly striking pregnant women. Due to the diminished activity of the immune system in pregnancy, these women may be even more susceptible to infection. As noted in the accompanying article, “during the H1N1 influenza pandemic in the United States, seventeen percent of infected pregnant women died; the mortality rate for the rest of the population was only 0.02 percent.” In a prior Ebola outbreak in 1995, 14 of 15 pregnant women infected died. Because pregnant women are assumed to have no hope, they are currently at the bottom of the triage list; …

Does This Year’s Flu Vaccine Work?

In Blog, Infections, Preventative/Primary Care, Women's Health Topics by Dr. Gary Goldman

Today the CDC announced that preliminary data from early flu virus surveillance has shown that about half of the flu present in the US currently is not directly covered by this year’s vaccine. What does this mean? – The types of flu covered by the annual vaccine are chosen 6 months before flu season, based on mapping flu strains around the world. In a typical year, about 70% of the strains of flu present are successfully anticipated by that year’s vaccine. Once the predominant strains are found, vaccine manufacturing begins, producing millions of doses in time for flu season. Over …

Gardasil 9 Approved for More Effective Prevention of Cancers

In Blog, Cancer, Cervical Cancer, Gynecology, Infections by Dr. Gary Goldman

Last week, the Food and Drug Administration approved the new Gardasil 9 vaccine, for the prevention of various diseases caused by nine types of Human Papillomavirus (HPV). It is not yet available for clinical use but should be over the next several months. The prior vaccine Gardasil, which was approved in 2006, covered four types of HPV: the two ‘low-risk’ types 6 and 11, which account for 90% of genital warts, and the two ‘high-risk’ types 16 and 18, which account for 70% of cervical and some additional cancers. Gardasil 9 affords the same protection against those same four types, …

Organic Food Recall

In Blog, Infections, Nutrition, Obstetrical Care, Women's Health Topics by Dr. Gary Goldman

The FDA announced a voluntary recall of multiple products from the commonly found organic food company, Amy’s Kitchen. The manufacturer has found that some spinach they had used in the production of various foods may contain Listeria, which can make any of us ill, and in particular can be problematic in pregnancy. I have seen these products for sale in Whole Foods as well as elsewhere. Fortunately, no one has reported an illness attributable to ingestion of Amy’s Kitchen products to date; the recall has been issued “out of an abundance of caution.” If you have recently purchased any of …

Zika Virus- What You Need to Know

In Blog, Infections, Obstetrical Care, Women's Health Topics by Dr. Gary Goldman

Fast Take The Zika virus has recently become more prevalent in certain regions, particularly in Central and South America and the Caribbean. When pregnant women catch this virus, their fetus can develop microcephaly, which is an abnormally small head and brain, and is associated with significant neurologic impairment and occasionally death. The virus is transmitted by certain species of mosquitoes; thus prevention of mosquito exposure is paramount in preventing the disease. In men and non-pregnant women, a Zika infection is usually mild and self-limited. There is no vaccine and no specific treatment. We are currently recommending avoiding travel to regions …

Zika Update #1: Important New Information

In Blog, Infections, Obstetrical Care, Women's Health Topics by Dr. Gary Goldman

‘ Fast Track: There are several more countries that have been added to the CDC’s list of places where Zika transmission has been reported, and to where you should not travel. Zika has been reported transmitted by sex, rather than by mosquitoes, in one case in Texas; this prompts new recommendations for disease prevention. Testing is now allowed for any individuals, not just for pregnant women, who have travelled to endemic regions within the last two weeks and have at least two symptoms. Today Governor Cuomo announced free testing for pregnant women in New York who have travelled to endemic …

Do We Need Vitamins?

In Blog, Cancer, Integrative Medicine, Nutrition by Dr. Gary Goldman

Many of my patients ask me if they should take a vitamin or nutritional supplement. 49% of us currently use at least one supplement daily. I answer that it depends who you believe. According to the US Preventative Services Task Force in their 2014 statement, “The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer.” In a word: no. They did carve out a rare exception, such as folic acid in pregnancy, or correcting a known deficiency. Many other groups …

Vaginas Aren’t What They Used to Be…

In Blog, Gynecology, Menopause, Sexuality by Dr. Gary Goldman

Between Mother Nature and Father Time, from childbirth to menopause, vaginas are subject to trauma, aging, and dysfunction. Problems can be numerous: vaginal laxity, diminished lubrication, painful intercourse, difficulty in achieving orgasm, decreased orgasm intensity, urinary incontinence, and pouting labia. Our options have been limited and often less than satisfactory. From fair quality over-the-counter lubricants to hormonal therapy with the potential for long-term adverse side effects, from surgical procedures requiring general anesthesia and long, painful recuperation, to Kegel exercises with disappointing results, these options are typically met with an understandable lack of enthusiasm. Finally, we have an ideal option that …