Only you can give your baby protection against whooping cough before your little one is even born. Talk to your doctor or midwife about getting the Tdap vaccine during your third trimester.

Whooping cough is a serious disease that can be deadly for babies. Unfortunately, babies can't get vaccinated and start building protection against whooping cough until they are two months old. The good news is that you can avoid this gap in protection by getting the whooping cough vaccine (called Tdap) during the third trimester of your pregnancy. By doing so, you pass antibodies to your baby before birth. These antibodies help protect your baby in the first few months of life.

You Need a Whooping Cough Vaccine during Each Pregnancy

Learn why Laura decided to get the whooping cough vaccine in her 3rd trimester and how her baby girl was born with some protection against the disease.
Also available on YouTube.

CDC recommends pregnant women get the whooping cough vaccine between 27 and 36 weeks of each pregnancy. This recommendation is supported by the American College of Obstetricians and Gynecologists  and the American College of Nurse-Midwives, healthcare professionals who specialize in caring for pregnant women. The goal is to give babies some short-term protection against whooping cough in early life.

The amount of antibodies you have from the whooping cough vaccine will decrease over time. That is why it's important for pregnant women to get a whooping cough vaccine during each pregnancy so that each baby has the benefit of getting the greatest number of protective antibodies. Getting the whooping cough vaccine while pregnant is the best way to help protect your baby from whooping cough in the first few months of life.

Whooping Cough Vaccine during Pregnancy Is Safe for Your Baby

Getting the whooping cough vaccine while you are pregnant is very safe for you and your baby. The most common side effects include redness, swelling, pain, and tenderness where the shot is given, body-ache, fatigue, or fever. Severe side effects are extremely rare. You cannot get whooping cough from the whooping cough vaccine. Learn more about safety and side effects.

Whooping Cough Is Making a Comeback

Whooping cough is a very contagious illness that is on the rise.

There are many factors contributing to this increase, but one key reason is that today's vaccines, while safe and effective, do not last as long as we would like. However, getting vaccinated is still the best way to prevent whooping cough and its complications.

View the latest U.S. whooping cough numbers.

Young Babies Are at Highest Risk

When babies—even healthy babies—catch whooping cough, the symptoms can be very serious because their immune systems are still developing. They can get pneumonia (a lung infection), and many have trouble breathing.

About half of babies who get whooping cough end up in the hospital. The younger the baby is when he gets whooping cough, the more likely it is that he will need to be treated in the hospital. Every year in the United States, up to 20 babies die from whooping cough, with most deaths in those too young to be protected by their own whooping cough vaccine.

More Information 

E-Cigarettes and Pregnancy is a free, online interactive presentation on electronic nicotine delivery systems and their potential health effects during and after pregnancy, and discusses effective tobacco cessation treatments.

The training is eligible for continuing education and Maintenance of Certification Part IV credit.

Learn more about continuing education.

The ABOG MOC standards now allow participation in ABOG-approved Simulation Courses to meet the annual Improvement in Medical Practice (Part IV) MOC requirement. This course has been approved to meet ABOG Improvement in Medical Practice requirements for 2016. Please review the 2016 MOC Bulletin for further information.

This computer program is protected by copyright law and international treaties. Unauthorized reproduction or distribution of this program or any portion of it may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This is subject to license agreements with Dartmouth College, and is not to be copied or used except as specified in such agreement. Some materials in this program are from copyrighted publications and products owned by others. Refer to the publication data included in bibliographic citations, and the copyright notices in the original published form of the contained publications, all of which are incorporated herein by reference.

The Inside Knowledge campaign raises awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. Inside Knowledge encourages women to pay attention to their bodies, so they can recognize any warning signs and seek medical care.

New television and radio public service announcements in English and Spanish feature actress Cote de Pablo, talking about her own cervical cancer scare, and sharing advice for other women. And check out the new posters telling Cote’s story, as well as our Behind-the-Scenes videos from filming!

Inside Knowledge also has new TV and radio PSAs that highlight gynecologic cancer symptoms. The PSAs encourage women to learn the symptoms, and pay attention to what their bodies are telling them.

Lesser-known conditions and diseases affect the health or safety of millions of women or girls each year. Learn about some of them and what you can do.

1. Asthma occurs more often in women than men. Older adults, women, and African Americans are more likely to die due to asthma.

• Women with asthma should always try to avoid asthma triggers.
• Known asthma triggers include pollen, mold and tobacco smoke.
• Know your triggers and learn how to avoid them.
• Work with your doctor to develop an asthma action plan that will help you take your medications correctly and avoid your asthma triggers.

2. Heavy menstrual bleeding, lasting more than seven days or very heavy, affects more than 10 million American womeneach year. That is about one out of every five women.

• A bleeding disorder may be the cause of heavy menstrual bleeding.
• Talk to your doctor or nurse if you have heavy menstrual bleeding to determine if you need testing.
• Learn about possible causes, including the signs and symptoms of a bleeding disorder.

3. About 27 million women in the U.S. have a disability , a condition of the body or mind that makes it more difficult to do certain activities and interact with the world around them.

• More than 50% of women older than 65 are living with a disability. The most common cause of disability for women isarthritis or rheumatism.

• Women with disabilities need the same general health care as women without disabilities, and they may also need additional care to address their specific needs. However, research shows that many women with disabilities may not receive regular health screenings, like mammograms or a Pap test, as recommended.

• Learn about tools and health resources for women with disabilities.

4. Infertility affects about 6% of married women ages 15-44. Also, about 12% of women 15 - 44 years of age in the U.S. have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status.

• Infertility is defined as not being able to get pregnant after one year of unprotected sex.
• Several things increase a woman's risk of infertility, including age, smoking, excessive alcohol use, extreme weight gain or loss, or excessive physical or emotional stress that results in the absence of a menstrual period.
• Infertility may be treated medically, surgically, or using assisted reproductive technology depending on the underlying cause.
• Assisted Reproductive Technology, also known as ART, includes all fertility treatments in which both eggs and sperm are handled.
• Learn more about what you can do to be healthy before, during, and after ART treatment. Resources are available for patients preparing for infertility treatment and pregnancy.

5. Bacterial vaginosis (BV) is the most common vaginal infection in women ages 15-44.

• BV is an infection caused when too much of certain bacteria change the normal balance of bacteria in the vagina. In the United States an estimated 21.2 million (29.2%) women ages 14–49 have BV.
• The cause of BV is unknown. BV is linked to an imbalance of "good" and "harmful" bacteria that are normally found in a woman's vagina.
• Basic prevention steps that may help to lower your risk of developing BV include not having sex, limiting the number of sex partners you have, and not douching.

6. Sex Trafficking is a serious public health problem that affects the well-being of individuals, families, and communities. The majority of victims are women and girls.

• Sex trafficking is defined as "the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act" by the Trafficking Victims Protection Act of 2000  .
• Consequences can be immediate and long term, including physical problems and relationship problems, psychological concerns  , and chronic health outcomes.
• Learn about what communities and groups can do to prevent trafficking.

7. About 19 women die every day as a result of drug overdoses involving prescription opioids.

• Women are more likely to have chronic pain, be prescribed opioid pain relievers, and use them for longer time periods than men.
• Addiction to prescription opioids is the strongest risk factor for heroin addiction, and heroin use has increased among women.
• Women should discuss all medications they are taking with their doctor and use prescriptions only as directed. Get help for substance abuse problems (1-800- 662-HELP); call Poison Help (1-800-222-1222) for questions about medicines, or see your pharmacist.

Soluble corn fiber (SCF) is a nondigestible carbohydrateused in foods and beverages such as cereals, baked goods, candy, dairy products, frozen foods, carbonated beverages, and flavored water.

SCF helps create packaged food products that have lower sugar contents, while providing a valuable source of dietary fiber.

Evidence suggests that SCF has many of the same health benefits associated with intact dietary fiber found in grains, vegetables, legumes, and fruit. SCF may improve intestinal regularity and has prebiotic properties. Moreover, SCF supports healthy blood glucose control and supports bone health by increasing calcium absorption.

The daily recommended fiber intake for adults in the United States is 25 grams for women and 38 grams for men. However, most Americans consume around half of the recommended amount. Fiber-enriched foods help bridge the shortage of fiber in the diet without significantly increasing calorie content.

In the new research, the team aimed to evaluate how the dose of SCF affected calcium absorption, bone properties, and gut microbiome in adolescent and postmenopausal women.

"We are looking deeper in the gut to build healthy bone in girls and help older women retain strong bones during an age when they are susceptible to fractures," says Connie Weaver, distinguished professor and head of nutrition science.

"Soluble corn fiber, a prebiotic, helps the body better utilize calcium during both adolescence and postmenopause. The gut microbiome is the new frontier in health," she adds.

Tate & Lyle Ingredients America LLC funded the research, and they produce Promitor Dietary Fiber, which is a soluble prebiotic fiber made from corn that is labeled as "soluble corn fiber" or "maltodextrin" on the packaging.

Findings from the study on postmenopausal women were published in American Journal of Clinical Nutrition, while the findings on adolescent women were published in Journal of Nutrition.

Weaver and colleagues found that after prebiotic fiber passes through the gut for the microbes in the lower gut to digest, the SCF is broken down into short-chain fatty acids, which assist in the maintenance bone health.

Supplementation helped build and preserve bone

In the postmenopausal study, 14 healthy postmenopausal women consumed 0 grams, 10 grams, or 20 grams of SCF every day for 50 days. The women in the groups that received 10 grams and 20 grams - amounts that are found in supplement form - displayed bone calcium retention improvement by 4.8 percent and 7 percent, respectively.

"If projected out for a year, this would equal and counter the average rate of bone loss in a post-menopausal woman," says Weaver, an expert in mineral bioavailability, calcium metabolism, botanicals and bone health.

In the adolescent study, 28 girls aged between 11-14 years old consumed either 0 grams, 10 grams, or 20 grams of SCF every day for 4 weeks, while maintaining their regular diet. The females in both the 10 gram and 20 gram SCF groups saw an increase in calcium absorption by around 12 percent, which would build 1.8 percent more skeleton per year.

Gastrointestinal symptoms were minimal in both studies and the same was seen in the control groups.

"Most studies looking at benefits from soluble corn fiber are trying to solve digestion problems, and we are the first to determine that this relationship of feeding certain kind of fiber can alter the gut microbiome in ways that can enhance health," Weaver said. "We found this prebiotic can help healthy people use minerals better to support bone health."

Few people meet the daily recommended intake of 1,200 milligrams of calcium for healthy bone mass.

Weaver says that while SCF can help people better utilize calcium for bone health, this finding does not mean the recommendation to drink milk and follow a well-balanced diet should be ignored. SCF can, however, help individuals that are not consuming the whole recommended amount of dairy.

"Calcium alone suppresses bone loss, but it doesn't enhance bone formation. These fibers enhance bone formation, so they are doing something more than enhancing calcium absorption."

Connie Weaver

Further studies by the team will examine the mechanisms behind how SCF boosts calcium absorption and retention, and if the prebiotic fiber benefits the body in other ways.

Read about how a diet high in fiber alters bacteria to protect against food allergies.

Written by Hannah Nichols

With concerns over a continued Zika outbreak growing, the Food and Drug Administration has given Roche Holdings emergency approval to use one of its Zika blood testing kits.

The approval, which lasts as long as the emergency is ongoing, will allow for testing of the virus through Roche's LightMix Zika rRT-PCR test, which has not been approved by the FDA yet.

The test uses the company's LightCycler 480 Instrument II or cobas z 480 Analyzer to search for Zika. The systems, found in specialist laboratories, can help detect the virus which can be more easily be found in blood samples. The disease can also be found in urine. On its site Roche says the cobas z 480 can process 384 samples per day.

The Roche emergency approval is the latest in the FDA's search to more quickly identify and contain the virus. The agency had previously approved nine other systems for detecting Zika since February under similar emergency use authorizations. It approved two systems that help detect the disease, one from InBios International and another from Luminex Corporation, earlier this month.

On Friday the FDA announced that all blood donations in the U.S. needed to be scanned for Zika, which over the last few weeks has spread into Florida and Puerto Rico.

Since officials revealed its presence in the state earlier this month over 40 people in the Miami-Dade and Palm Beach counties in Florida have been diagnosed with the virus.

The FDA updated its guidance due to the potential serious health consequences of Zika to pregnant women and children born to women exposed to the virus during pregnancy. The Zika virus is transmitted primarily by the Aedes mosquito but can also be spread by sexual contact. Although most people infected with the virus never develop symptoms, an infection during pregnancy can cause serious birth defects and is associated with other adverse pregnancy outcomes, the FDA warns.

Contributing: Doyle Rice 

New CDC downloads available:

ZIKA VIRUS TESTING FOR ANY PREGNANT WOMAN NOT LIVING IN AN AREA WITH ZIKA - Download

When to test for Zika Virus - Download

August 26, 2016

On August 11th NCCPA announced that effective immediately, self-assessment CME and PI-CME are no longer required. What does this mean for PAs?

In 2014 NCCPA began transitioning PAs to a 10-year certification maintenance process that incorporated requirements for self-assessment and performance improvement (PI) CME credit. With the first PAs who transitioned to the new 10-year process facing a December 2016 logging deadline, NCCPA evaluated the self-assessment and PI-CME options currently available to PAs and determined they were insufficient to maintain self-assessment and PI-CME as requirements.

For many PAs, self-assessment and PI-CME were only on the horizon, not demanding attention until they transitioned to the new 10-year process at some point in the next few years. Other PAs, however, have already expended resources participating in self-assessment and PI-CME activities.

PAs who have already completed self-assessment or PI-CME activities will still be able to log these and will actually receive an additional benefit. Acknowledging the evidence of the positive impact of self-assessment and PI-CME on outcomes, NCCPA also announced new incentives for completing self-assessment and PI-CME activities: PAs will receive an additional 50% weighting for all self-assessment credits logged with NCCPA and the first 20 PI-CME credits logged during every two-year cycle will now be doubled.

For those PAs who have already completed and logged self-assessment and PI-CME activities, the additional credit weighting will be applied retroactively. Changes will be reflected in the NCCPA’s logging system and individual PA dashboards at some point during the next few months.  

PAs should be aware that the additional weighting for self-assessment and PI-CME activities applies only to NCCPA certification. States that require CME for license renewal purposes do not apply any additional weighting for self-assessment or PI-CME. For state license purposes, PAs must claim those credits exactly as awarded on their CME certificates.

Many PAs have questions about these changes, how and when it will affect them, and how it relates to them and their own career path. You can find the answers to many common questions in our Certification Maintenance FAQ.

AAPA will continue to provide and accredit high quality, affordable self-assessment and PI-CME activities to keep PAs ahead of the curve as healthcare moves toward a value-based system. With the new weighted logging system, PAs now have an additional incentive to participate in these interactive and impactful activities. 

- See more at: https://www.aapa.org/twocolumn.aspx?id=6442451548#sthash.Ld6A1VVT.dpuf

Centers for Disease Control and Prevention 
Everyone has a role to play in protecting their community from viruses spread by mosquitoes, like Zika. It is especially important to protect pregnant women from getting Zika because infection during pregnancy can cause microcephaly and other serious birth defects. Pregnant women can take certain steps to protect themselves and their pregnancy from Zika, such as avoiding travel to areas with Zika, protecting themselves from mosquito bites, and protecting against sexual transmission.

Using an Environmental Protection Agency-registered insect repellent, treating clothing and gear with permethrin, and controlling mosquitoes inside and outside the home can protect against mosquito bites. Condoms (and other barriers to protect against infection) can reduce the chance of getting Zika from sex. Pregnant women who have recently traveled or who have a partner who traveled to an area with Zika should talk to their healthcare provider about their travel even if they don't feel sick. Share information with other moms-to-be about how to protect your pregnancy from Zika virus infection!

Postmenopausal women with osteoporosis assigned once-daily abaloparatide injection experienced a lower rate of vertebral and nonvertebral fractures during 18 months vs. those assigned teriparatide or a placebo, according to results from a randomized controlled trial.

“This new medication, abaloparatide, can build bone mass very quickly in both the spine and the hip which are the two most important sites for osteoporosis-related fractures,” Felicia Cosman, MD, medical director of the clinical research center at Helen Hayes Hospital, senior clinical director of the National Osteoporosis Foundation and professor of medicine at Columbia University, told Endocrine Today. “The result of this bone building is a rapid reduction in the occurrence of fractures in both the spine as well as the rest of the skeleton. This represents a great potential treatment for osteoporosis-afflicted patients for the future.”

Cosman, Paul D. Miller, MD, FACP, medical director of the Colorado Center for Bone Research, and colleagues , and colleagues analyzed data from 2,463 menopausal women participating in the ACTIVE trial, a phase 3, double blind, randomized controlled study conducted at 28 sites in 10 countries (mean age, 69 years). Participants had a bone mineral density T-score of up to –2.5 and greater than –5 at the lumbar spine or femoral neck, together with evidence of at least two mild vertebral fractures or one moderate vertebral fracture, or a low-trauma fracture of the forearm, humerus, sacrum, pelvis, hip, femur or tibia within 5 years. Women older than 65 years without fracture history were included if BMD T-score was –3 or less and at least –5 at the lumbar spine or femoral neck (mean femoral neck T-score, –2.1). Researchers assigned women to daily injections of abaloparatide (Radius Health; 80 µg; n = 824); open-label teriparatide (Forteo, Eli Lilly; 20 µg; n = 818) or placebo (n = 821) for 18 months. The primary endpoint was the percentage of women with new vertebral fractures in the abaloparatide vs. placebo groups; secondary endpoints included BMD change at total hip, femoral neck and lumbar spine and time to first incident of vertebral fracture in the abaloparatide vs. placebo groups.

Researchers found that participants in the abaloparatide group experienced fewer morphometric vertebral fractures during the study period (n = 4; 0.58%) vs. the teriparatide group (n = 6; 0.84%) and placebo group (n = 30; 4.22%). Comparing abaloparatide with placebo, the RR for new vertebral fracture was 0.14 (95% CI, 0.05-0.39); HR for nonvertebral fracture was 0.57 (95% CI, 0.32-1).

When compared with placebo, participants assigned to abaloparatide also saw increases in BMD from baseline during the 18-month period at the total hip (4.18% vs. –0.1%), femoral neck (3.6% vs. –0.43%) and lumber spine (11.2% vs. 0.63%).

Serious, treatment-emergent adverse events were similar between abaloparatide, teriparatide and placebo groups (9.7%, 10% and 11%, respectively). Overall incidence of hypercalcemia was lower in the abaloparatide group vs. teriparatide group (3.4% vs. 6.4%) at any time during the study. Researchers did not observe evidence of increased cardiovascular risk associated with hypercalcemia in the abaloparatide group.

Cosman noted that the findings apply to women with a fracture history, as well as those with very low bone mass who have not had fractures; however, more research is needed on the drug’s effect on other groups.

“We need to continue evaluate abaloparatide in other clinical settings,” Cosman said. “We would like to see if this medication is just as efficatious in men, for example, and how efficatious it is in people who have been on other osteoporosis therapies.”

Drug developer Radius Health submitted a new drug application to the FDA for abaloparatide on March 30. The company submitted a marketing authorization application in Europe on Nov. 17.

“We are honored to have these findings published in JAMA, and are encouraged by the totality of data collected to date which demonstrate that abaloparatide, if approved, could have a significant impact in improving outcomes for women with postmenopausal osteoporosis,” Lorraine A. Fitzpatrick, MD, chief medical officer of Radius, said in a press release. “We look forward to presenting additional scientific information about abaloparatide as part of theAmerican Society for Bone Mineral Research (ASBMR) Annual Meeting in Atlanta, Georgia September 16-19, 2016.” – by Regina Schaffer

Disclosure: The study was funded by Radius Health. Miller reports serving on scientific advisory boards for AgNovos, Amgen, Eli Lilly, Merck, Radius Health, Roche, and Ultragenyx; receiving research grants from Alexion, Amgen, Boehringer Ingelheim, Daiichi-Sankyo, Eli Lilly, Immunodiagnostics, Merck, Merck Serono, National Bone Health Alliance, Novartis, Radius Health, Regeneron, Roche Diagnostics and Ultragenyx; and serving on data safety committees for Allergan and the Grunenthal Group. Please see the full study for the other authors’ relevant financial disclosures.

Source: Miller PD, et al. JAMA. 2016;doi:10.1001/jama.2016.11136.