healthy body tips

The cost of a drug used to prevent premature birth in high-risk mothers will rise from around $10 per dose to $1,500, now that the FDA has approved a branded version of the medication. The new medication is a form of progesterone, which has already been prescribed for decades and is currently made for this purpose by specialty drug stores known as compounding pharmacies.

Now, KV Pharmaceutical Company, the maker of the new drug called Makena, has warned compounding pharmacies that they face FDA action if they continue to sell nonbranded versions of the drug, technically known as 17-hydroxyprogesterone caproate. KV's new price means the drug could cost mothers up to $30,000 per pregnancy — but some doctors and pharmacists say there may be ways to avoid the massive price increase. 

But first, why has a drug that has been used for decades suddenly become so expensive? Premature birth affects 1 in 8 pregnancies — some 543,000 annual births — resulting in intensive care and often lifelong disabilities in the child. It's responsible for $26 billion a year in medical expenses — a figure KV cites to justify the new price of Makena.

To help offset the cost of the weekly injection, KV just announced a patient-assistance program for families in financial need. "We established this comprehensive patient-assistance program as part of our commitment to ensure that all eligible women have access to FDA-approved Makena," KV's CEO Greg Divis said in a statement.

The March of Dimes — which has received hundreds of thousands of dollars in donations from KV's subsidiary Ther-RX, which will market Makena — supports the introduction of the new drug. "An FDA-approved product is a good thing," says Dr. Alan Fleischman, medical director of the March of Dimes. "The drug is expensive but it's a very important drug for a very important purpose. The company has promised that every eligible woman whose doctor prescribes it will [be able to receive it] and ability to pay will not preclude that." 

But many other doctors expressed outrage over the price hike. "This is ridiculous. This medicine has been used for 40 or 50 years," says Dr. Sam Kim, division director for reproductive endocrinology and infertility at the University of Kansas Hospital.

"It's going to be prohibitively expensive for a lot of patients," says Dr. Robin Kalish, director of clinical maternal-fetal medicine at New York-Presbyterian/Weill Cornell Hospital in Manhattan. She adds that much of the research on the drug— including a major 2003 study showing that the drug cuts premature birth by one third in women carrying single pregnancies who'd previously had premature babies—was funded by the government.

Since low-income women are at high risk for premature birth, the burden of cost for Makena is likely to fall to Medicaid, which is already facing massive budget cuts in many states. Matt Salo, executive director of the National Association of Medicaid Directors told the AP: "There's no question they can't afford this."

The March of Dimes' Fleischman responds: "The Medicaid programs and the insurance companies have only begun their discussions with the company." 

Already, many patients and doctors may be wondering whether they can use other types of progesterone to lower the risk of premature birth, without paying for Makena. Indeed several types are already on the market. Almost all women who have been through in-vitro fertilization (IVF) have taken some form of the hormone, either as a vaginal suppository or intramuscular injections, which are one of the most uncomfortable parts of the procedure. Those drugs will still be available at their current prices, but they must be used daily, rather than once a week like Makena.

"It is possible to use daily gels, creams, suppositories [or injections]," says John Preckshot, director of marketing of the Professional Compounding Centers of America, the leading trade organization representing specialty pharmacies. Many of these drug stores currently make versions of weekly hydroxyprogesterone to prevent premature birth.

A small Brazilian study found that daily vaginal progesterone does work to reduce the risk of premature birth, notes Kalish, but that was just one small study. 

Preckshot adds that compounding pharmacies may still be able to make a different version of hydroxyprogesterone that would not violate the patent on Makena. "There's the possibility of using different vehicles, other oils, than the one used in Makena," says Preckshot, who is also a compounding pharmacist himself.

"Compounding pharmacies have already been making this for the patient," says Dr. Kim. "The problem is that depending on the pharmacy and depending on who is making it, it varies — there is not always the same level [of the hormone in the product]. That's the reason the company took over, but I don't have any problem if compounding pharmacies can continue to do it."

Still, liability issues may deter doctors from using other options, now that a branded product has been federally approved. Moreover, the alternatives have not been tested. "Theoretically, you could use any progesterone. The problem is, there are no studies [of most of these alternatives]. And it's impractical to give daily intramuscular shots for so many months," says Dr. Zev Rosenwaks, director of the Cohen/Perelman Center for Reproductive Medicine at New York-Presbyterian/Weill Cornell.

Now, it seems the business interests of KV, insurance companies, compounding pharmacies, government policies and doctors will determine how Makena will affect prematurity rates and high-risk women's access to a substance which could mean the difference between a normal life and one of severe disability for thousands of babies.

Parents often reach for medication too quickly when their children develop fever. A new report from the American Academy of Pediatrics (AAP) recently published in the journal Pediatricssuggests that intervention is not necessary for fevers alone. 

According to lead author Dr. Janice Sullivan, “The focus should be on comfort and not on absolute temperature.” The onset of fever is the body’s way of fighting off illness by jump-starting the immune system and slowing the progression of bacteria and virus growth. Sullivan acknowledged that these benefits provided by fever “may shorten the time that your child remains ill.” Parents need to be aware that although fever is an indication that a child is ill, a visit to the family doctor may not be necessary unless there are accompanying symptoms such as lethargy, pain or dehydration.

The report included the first guidelines to be released by the AAP for the treatment of fever with over-the-counter medications. The authors emphasized that the primary goal in treating fever is to improve overall comfort level comfort level of the child.

According to the guidelines, this is best achieved with the use of fever-reducing drugs such as acetaminophen (Tylenol) or ibuprofen (Motrin and Advil). The recommended dosage for acetaminophen is 10 to 15 mg/kg every 4 to 6 hours, and 10 mg/kg for ibuprofen.

The researchers pointed out that existing evidence shows no difference in effectiveness between ibuprofen and acetaminophen for the reduction of fever symptoms, although some evidence shows that a combination of the two products given in alternate doses may be beneficial. However, the researchers warned that adverse effects may be associated with this regimen and that it is more confusing for parents to administer.

Caution is advised even when given separately, as both drugs are known to have rare side effects. Ibuprofen may carry a risk of being toxic to kidney cells (nephrotoxicity), particularly among children suffering from dehydration or complex medical illnesses. Similarly, acetaminophen can cause chemical-driven liver damage (Hepatotoxicity) in association with acute overdose. Hepatitis may also develop from chronic overdose stemming from a build up of the medication in the body due to regular dosages given over long periods of time.

To avoid overdosing children with fever-reducing medications, the guidelines remind parents to use proper dosing techniques. Dosage is determined by weight, not age or height. In addition, when giving a child fever-reducing medication, use the correct dosing devices, and not kitchen teaspoons, since they vary widely in size, and can lead to both over-treatment and under-treatment.

Parents are also advised not to wake children to administer medication. Sullivan said, “We discourage parents from waking their children to give them antipyretics (fever-reducing medications), because if their child is sleeping, there's no sign of discomfort.”

Parents are encouraged not to give their children cough or cold medicine that includes acetaminophen or ibuprofen in addition to administering fever-reducing medications. Sullivan noted that parents are often unaware that the drugs are among the ingredients in cough syrups, and wind up double-dosing their children with fever reducer. As an alternative to the use of drugs for the reduction of fever, parents can also try treating childhood fevers naturally.

Although fever alone need not be cause for alarm, parents are advised to closely monitor their children for signs of serious illness, and to be sure to keep their children properly hydrated. If your child continues to worsen, contact your pediatrician.

Studies suggest that adolescents often sacrifice their sleep time in making decisions about time management. The problem is that studies also show that sleep need much more likely to get. More and more studies are showing that there is a direct relationship between sleep and academic success.

According to a study by sleep expert Mary Carskadon, PhD, adolescents should receive more than nine hours of sleep each night. That's a great thought, but is it possible? Think about it - do you ever sleep so long?

OK, maybe the weekend. But very few teens get enough sleep on school nights.

Dr. Carskadon's study suggests that biology may be the cause of sleep deprivation among adolescents. Their internal clocks are a little different during adolescence - and the late nights and sleep ins are a natural part of growing into adulthood.

Lack of sleep makes it more difficult for students to concentrate in school, especially during the early morning classes.

Our ability to recall is related to our ability to learn, and there have been many studies on sleep and its effects on memory, learning and retention. These studies suggest that sleep habits are essential to good study habits.

A study on the learning of languages shows that it is good to study law before going to sleep because "there is almost consensus that sleep promotes learning of certain types of perceptual memories. "In other words, the students sleep helps store memories to be retained and recalled the next day.

Another study shows that sleep strengthens the memory to be clear and resistant to interference and distractions.

These studies show that sleep is important, but also suggest that there may be more useful to study right before bedtime.

Turn off the TV at night. Some teens fall asleep with the TV on, and some are so used to the noise they think I can not sleep without it. Not true! TV noises and flashing lights will only continue to get a deep sleep. If you can remember everything you hear in your dream, is a sure sign that you're not sleeping well.

Try switching to decaffeinated beverages. caffeine by switching to something healthier, and reduce bottled water. If that's too much to ask, at least try a caffeine free version of your favorite beverage!

Limit extracurricular activities. It is hard to do, but try to limit their extracurricular activities. Decide once and for all if good performance and potential of the university is important, and then set priorities. Sometimes you have to make a tough decision and stick to it.

Too does not seem right before bedtime. If you have the task of calculation, you may not want to leave for the night. It's harder to relax and sleep when your mind is stuck so deep in thought. It takes a while to relax, so perhaps I should deal with more subjects before.

Ditto for video games crazy. Video games can also cause your brain to enter the zone of saturation. If you play video games, they do before going to bed.

Turn off your cell phone. What is so important that it can wait until tomorrow? Unless you have a good reason (as an employed parent has to go) to go out and get some rest.

Keep track of time. Often, students have great intentions, but other things seem to keep them up late, again and again. That's because teenagers need to develop an understanding of time management and complete the task. It is difficult to put a timetable on things like running an errand or do a scientific experiment.

Start tracking the things you do normally and the amount of time required to perform certain tasks. Then, plan ahead so you can get to bed on time.

Listening to music, if desired, but not too strong. Many people play music at night. If you do not mind, go ahead. Do not play too hard, though, or will interfere with your sleep.

Do you really need to work after school? This could be a very difficult decision, too. Some students need to work to pay car insurance or save for college. You just have to decide on their own, which is necessary and what not.

The number of running-related injuries suffered by young Americans aged 6 to 18 increased 34 percent between 1994 and 2007, according to a new study.

During that period, there were an estimated 225 344 such injuries treated in U.S. departments hospital emergency department, averaging over 16,000 per year.

Most running-related injuries were sprains and strains to the lower extremities. Falls account for one third of injuries and more than half of the injuries occurred at school, researchers said at the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Youth ages 6 to 14 were more likely to suffer injury as a result of a fall and while running at school, while adolescents aged between 15 and 18 years were more prone to injury when running in the street or in a facility sports and recreation.

"Encouraging children and adolescents to run for exercise is a good way to ensure they are physically active," said Lara McKenzie, principal investigator at the center, in a press release from the hospital. "However, the results of our study show that the official guidelines, evidence-based and age are needed for pediatric corridors for parents, coaches and physical education teachers can teach children the correct way to execute To reduce the risk of injury. "

The child's first teeth will begin to arrive between three and sixteen months (usually around six months). The two lower front teeth will be the first to enter and this will be followed by the four upper teeth in four to eight weeks. The time of eruption of first tooth is largely influenced by genetics, so if you have a family history of getting the first tooth late, your child will probably get his first tooth late.

Your child will still get new teeth until he has all twenty of his baby teeth when three years, with most children receiving about four new teeth every four months. Children begin to shed their baby teeth when they are around 6-7 years old, and this process is completed with the loss of the second molars when it comes to 11-13 years of age.

Permanent teeth begin erupting around 6-7 years of age and continues until the child gets his third molars (or wisdom teeth) when it comes to 17 to 22 years of age.

In most children, teething only causes increased drooling and a desire to chew hard things, but in some it does cause mild pain and irritability and the gums may be swollen and painful. To help it can massage the area vigorously for a few minutes or let him chew a ring smooth, hard teething. Teething does not cause fever, diarrhea, sleeping problems or diaper rashes. Although most children do not need teething gels or treatment with Tylenol for pain, use these products if necessary.

Once your child's teeth begin erupting, you can start by wiping clean with a damp cloth. As your child gets more teeth, you can start using a soft infant toothbrush is. You should use only a pea-sized amount of toothpaste with fluoride or without fluoride toothpaste (like Baby Oragel) until the child is able to spit (too much fluoride can stain teeth.)

In accordance with the recommendations of the American Academy of Pediatric Dentistry, the first dental visit should be when the first tooth, usually between six and twelve months. "

The American Academy of Pediatrics recommends the first dental visit is three years old. Now, because many children have caries by the time they enter kindergarten, the AAP says that children at high risk should consult a dentist six months after their first tooth, or before they are 12 months old.

In addition to analyzing and preventing problems, an early visit to the dentist can help educate you about your child's oral health and hygiene. If your child is high risk, the doctor must begin oral health assessments at six months old.

So when should be the first visit? If your child has no risk factors for developing cavities, such as sleeping with a cup or a bottle or walk all day with a cup of juice, and if your teeth seem to be developing normally, then you can probably wait until your child is more and just ask your doctor to check your teeth in each well-child visit.

Another risk factor for a large number of cavities can include having a mother with a lot of cavities. In addition, children with special health needs, descendants later order, and children from families of low socioeconomic status are considered at risk of caries and probably should see a dentist early.

If your child has a problem, as the staining of teeth, tooth development abnomal crowded, or if you have any risk factors for developing cavities, then you should see a dentist before. You may also want to see a dentist if your child has persistent habits such as thumb sucking or using a pacifier as a toddler or grinding your teeth at night (bruxism).

If your family dentist tells you that your first visit should be delayed until it is four or five years, then you may want to see a pediatric dentist early.

In general, yes. All children need supplemental fluoride after six months of age to help prevent cavities. For most children, can get this fluoride in drinking water, if they are in an area where the water supply of the city has an adequate amount of fluoride (more than 0.6 ppm), and are drinking water tap.

Water sources usually do not have enough fluoride include well water and filtered or bottled water, although some brands of bottled water (water or nursery) have fluoride added. In addition, commercially prepared infant formulas do not contain a mix adaquate amount of fluoride, so consider using a powder or concentrated formula and mixing with tap water, supplement your infant with extra tap water, or talk to your Pediatrician about giving fluoride supplements.

If you only use a water pitcher filter or countertop filter, you may not remove fluoride from water. Other types of water filters, although it could. If you have any questions, please contact the manufacturer of the filter.

In general it is better to have the child drink water that is supplemented with fluoride instead of giving additional drops or fluoride supplements. Too much fluoride can cause fluorosis, which is white permanent brown discoloration of the tooth enamel. It is easier to get fluorosis if you are giving your child fluoride drops and is still getting fluoride from their diet.

Talk to your pediatrician or pediatric dentist if you think your child may need fluoride supplements.

In addition to the intrinsic stains, which can be caused by fluorosis, blood and bile pigments, inherited defects of dentin and enamel, medications (especially tetracycline), and trauma, the teeth may also be extrinsic staining of bacteria and food stains.

Sealants are usually applied to the back teeth to help protect the grooves and pits of these teeth that can be difficult to clean and are prone to develop caries. A sealant is a plastic material applied to the teeth, hardens, and provides a barrier against plaque and other harmful substances. Sealants should be applied to the premolars 1 and 2 and appropriate permanent molars as soon as possible after they erupt (usually after 6 years of age).