Nathan Littauer Hospital first in area to offer noninvasive screening techniques for chromosomal disorders

Nathan Littauer Hospital first in area to offer noninvasive screening techniques for chromosomal disorders

During first trimester of pregnancy Nuchal Translucency combined with maternal blood testing identifies markers for Down syndrome.

Gloversville, NY — The Diagnostic Imaging Center and the Ultrasound Department at Nathan Littauer Hospital has added a new noninvasive genetic screening technique to its out-patient prenatal testing program for pregnant women.

Dr. McBiles reviews a file with Kaylee Palmer, as they now offer Nuchal testing

Dr. McBiles reviews a file with Kaylee Palmer, as they now offer Nuchal testing

“Nuchal translucency” is a test performed by high-resolution ultrasound early in the first trimester to identify risk factors for Down syndrome, a genetic disorder that affects one in every 733 babies in the United States. “This competency really distinguishes us as a resource to expectant mothers and practitioners in our region” stated Dr. Mike McBiles, Chief of Radiology at Littauer. He added, “Our technologist, Kaylee Palmer who relocated here from Boulder Colorado, studied with the pioneer of prenatal testing, Dr. John C. Hobbins.” Dr. McBiles explained, “Mrs. Palmer was part of the original trial when the technology was first in use. Her expertise makes her an invaluable asset to this area.” He quipped, “It is a bit like having Colonel Sanders cook your chicken in your kitchen.”

Nuchal translucency is a first-trimester risk assessment available at Nathan Littauer Hospital measuring the neck of fetuses between 11 and 14 weeks of gestation. The noninvasive ultrasound procedure can identify genetic abnormalities such as Down syndrome in combination with maternal blood testing. Nuchal translucency measures the amount of fluid behind the neck of the fetus, in an area known as the nuchal fold or nuchal translucency. It is believed that the higher the amount of soft tissue around the neck, the higher the risk for Down syndrome. These tests also screen for two less-common genetic disorders, trisomy 13 (Patau syndrome) and trisomy 18. “We are credentialed, we have completed our tests and we are now testing mothers.” said Barbara Tambasco, Ultrasound Department Manager for Nathan Littauer.

Nathan Littauer Hospital is the first center in the Fulton, Montgomery area to offer the screening techniques “The combination of the nuchal measurement and blood test gives us about a 91% accuracy rate.” stated Dr. McBiles. Dr. McBiles and Dr. Saqib are now credentialed radiologists for the test. In addition, two sonographers at Nathan Littauer Hospital are in the process of earning their certification from the Nuchal Translucency Quality Review Program of the Maternal-Fetal Medicine Foundation. This national education and quality review program was created to ensure the highest levels of accuracy and quality in first-trimester Down syndrome screening.

In 2007 the American Congress of Obstetricians and Gynecologists (ACOG) recommended routine Down syndrome screening and genetic counseling for all pregnant women, regardless of age, before the 20th week of pregnancy. Babies with Down syndrome are born with an extra copy of chromosome number 21, which causes mild to severe delays in physical, cognitive, and language development, as well as health problems such as congenital heart defects, thyroid disease, and digestive disorders. The risk of having a baby with Down syndrome increases with the age of the mother. The risk is one in 365 babies at age 35, one in 100 at age 40, and one in 30 at age 45.

“This test is non-invasive, quick and gives the family vital information.” explained Kaylee Palmer, adding, “Women in this area should be very relieved they do not have to travel to major metropolitan areas to get this test.” Kaylee Palmer has performed thousands of the tests throughout her career. She states, “My goal is to have every patient leave happier than when they came in.” She concluded, “I really enjoy my patients.”

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Dr. Shen heard on WAMC- spanning seven states

Dr. Shen takes to the airwaves to talk about complete spine care

Dr. Shen (left) pictured with Dr. Alan Chartock at WAMC studios

Dr. Shen (left) pictured with Dr. Alan Chartock at WAMC studios

Dr. Shen, who recently completed a ground-breaking surgery for our region at Nathan Littauer Hospital , was a featured guest on WAMC’s Medical Monday with Dr. Alan Chartock. The show first aired Monday, August 15, 2011. Littauer’s Hospital spokesperson Cheryl McGrattan explained, “Medical Monday is a showcase for the states’ best and brightest physicians. It is truly an honor to sit at the microphone with Dr. Chartock.” The show is heard on seven states. During the interview he also took calls from people who are suffering with orthopedic issues. To reach Dr. Shen’s please call his office at 518-773-4242.

To hear the entire Medical Monday show press here:

Teams taking precautions to beat the heat

Teams taking precautions to beat the heat

August 15, 2011
By ERICH NEUHAUS , The Leader Herald

 

Believe it or not, practice for high school football teams starts today.

Bill Oates delivers heat related illness information to the coaches at Broadalbin Perth School system

Bill Oates delivers heat related illness information to the coaches at Broadalbin Perth School system

It’s hard to believe the unofficial end to summer for high school athletes is already here as they get a jump start on their school year by preparing for the upcoming sports season.

In reality, though, summer doesn’t officially end until Sept. 23, so the temperatures will still be summerlike for weeks, which is a cause for concern for coaches and athletes, especially football coaches, when it comes to practice routines.

Hot temperatures, combined with the extra weight of helmets and pads, can expedite dehydration, which can be a recipe for a fatal scenario if not monitored.

The National Center for Catastrophic Sport Injury Research’s annual football injuries research reported 13 heat-related deaths among high school and middle school football players since 2006, which is why the Nathan Littauer’s Sports Medicine and Rehabilitation team is stressing the importance of hydration throughout practice by offering a free 45 minute Beat the Heat seminar to area coaches.

“The coaches are educated on the warning signs and how to go about responding to such an emergency,” said Bill Oates, director of Sports Medicine and Rehabilitation at Nathan Littauer, who heads the Beat the Heat program. “It is a growing epidemic across the United States, and we’re just trying to provide as much information as we can.”

The hydration program, which has already been presented at Broadalbin-Perth High School and will be presented at Johnstown High School in September, offers a variety of tips for coaches as they prepare to practice throughout the warm summer days in the rest of August and early September.

Oates said younger athletes are more at risk for dehydration than adults for several reasons.

“Kids really don’t tolerate heat in the same ways as adults do,” he said “Their sweating threshold is higher, so it takes them more to sweat. Their exercise tolerance is shorter, their acclimation to heat is slower, and their core temperature rises faster. Those four things can kind of drastically increase the risk for a young athlete compared to an adult.”

One of the program’s suggestions that’s specifically effective for today as the teams begin to work for the first time after the summer break, is a period of acclimation.

“It’s a 10-day period or so to get them accustomed to the conditioning and accustomed to the heat,” Oates said. “A lot of athletes show up for sports in fairly poor conditions at times. They don’t maintain that level of cardiac fitness throughout the entire year and they also are not accustomed to two-a-days.”

The seminar also touches on who is considered at high risk for dehydration and encouraging coaches to teach their players about signs of dehydration.

Broadalbin-Perth head football coach Jim Pelneau, who is entering his first year with the Patriots, has seen the hydration program run by Oates and Nathan Littauer and already is making preparations to put them into his team’s practice routine.

“You learn to work those things into your practice schedule,” he said. “We are much more aware of it than maybe we have been in the past.”

Heat is obviously a major factor that leads to dehydration, and recently, Section II made recommendations about practices should be run during extreme heat.

Anything over a RealFeel – an index that takes into account temperature and humidity – temperature of 96 degrees will result in a cancelled practice or contest.

When the RealFeel is 91-95 degrees, Section II recommends teams provide water breaks every 15 minutes, and also suggests reducing the practice time. When the RealFeel temperature is above 86, coaches should allow an hour of recovery time for every hour of practice,?Section II?suggests.

Oates said temperatures from 74 to 82 degrees create a high risk for dehydration, while anything over 82 degrees is considered extremely high-risk. He said sometimes more recovery time is needed what Section II suggests.

“You have to take into account the temperature and the intensity of the exercise,” Oates said. “If you do a two-to-three hour practice in 85 degree heat, and you’re really working them, three hours probably isn’t sufficient – especially for young people.”

Fonda-Fultonville head football coach Tom Carpenter said he likes to keep his team from practicing in the heat of the afternoon.

“When we usually do doubles, we go at 8 a.m. and at 5 p.m.,” he said. “We try to go at the coolest parts of the day.”

A lot of dehydration incidents occur toward the beginning of the season, when athletes may be vying for a spot on the roster or starting position on the field. There’s a chance young athletes may say they’re OK even when they feel exhausted, Carpenter said.

“You try to tell the kids to be honest with you,” Carpenter said. “If you’re not feeling good, say something.”

William Oates, Director of the Sports Medicine and Rehabilitation services at Littauer.

William Oates, Director of the Sports Medicine and Rehabilitation services at Littauer.

For information on the Beat the Heat program at Littauer, contact Bill Oates at 773-5540.

New endoscopic spinal surgery promises shorter recovery time

(First printed in Daily Gazette)
New endoscopic spinal surgery promises shorter recovery time
Tuesday, August 16, 2011
By Marcy Velte
Gazette Reporter

GLOVERSVILLE — A groundbreaking spinal surgery that is minimally invasive and comes with a faster recovery period is now being performed at Nathan Littauer Hospital.

Dr. Jian Shen, an orthopedic surgeon who specializes in complex spine care, completed the first endoscopic cervical spine surgery in the area at the hospital Friday. The technique causes less muscle damage and less irritation than the typical cervical spine surgery.

“It’s basically a decompressing procedure,” said Shen, who explained that the surgery involves removing a bone spur, cyst or herniation that is compressing a nerve. The procedure is designed to improve patient discomfort.

The procedure is about 5 years old but so far has been performed only in San Francisco, Chicago and Texas.

Shen said the reason why more doctors aren’t performing the surgery may be because “people get used to the open procedure and it’s hard to change.”

“But once you get used to [the newer procedure] there is no return because it’s so much better,” he said.

The procedure uses an endoscope, a device with a long, thin, flexible tube with a light and camera at the tip. The video feed then goes to an HDTV that the doctor uses to view the area. It requires an inch-long incision, while other methods use a large, midline incision almost five times longer.

“I think this is really good,” said Shen. “There’s less blood, less pain, a shorter recovery and less muscle damage.”

The first local patient was a man with a rare spine disease.

“The patient reports [he] already feel[s] a difference from surgery,” said Shen. “Although it is early in the recovery process, the patient already has improved range of motion.” The patient, whose name is not being disclosed for privacy reasons, was discharged from the hospital Saturday.

The family was also grateful. “We have waited for Dr. Shen to come here. We are very pleased to be in his care,” they said in a news release.

Hospital President and CEO Laurence E. Kelly stated: “According to our research, only a few academic centers in the United States perform this type of surgery. Obviously we are thrilled for this patient and for others in our region who suffer with spine problems.”

Shen finished his fellowship at University of California, San Francisco, earlier this year before joining the staff of Nathan Littauer in July.

Previously, he earned a Ph.D. in basic science research in pharmacology, finished his medical education at Cornell University Medical College in New York City, did a surgical internship at the Mayo Clinic in Rochester, Minn., and completed an orthopedic surgery residency at Wake Forest University Medical Center in Winston-Salem, N.C. He is versed in minimally invasive and complex spine surgery, as well as nonsurgical techniques and therapies.

Dr. Shen chose the Gloversville area because he wants to interact personally with each patient so they “do not feel like a number.” He said working at Littauer allows him to do that and he plans to stay in the area.

“With Dr. Shen’s arrival, we now say, ‘Spines everywhere can rejoice,’ ” Kelly said in the news release.

Wellness Words August 2011

HealthLink Littauer’s

WELLNESS WORDS

Submitted by Ryan Wille, B.S.

Community Health Educator

HEAT-RELATED ILLNESS

 

The summer months are filled with hot days that can put individuals at risk of developing heat-related illnesses, such as heat exhaustion and heatstroke. Heat-related illnesses occur when the body can not keep itself cool. As the air temperature rises, the human body stays cool when sweat evaporates. However, the evaporation of sweat is slowed down by increased moisture in the air on hot and humid days. When sweating isn’t enough to keep the body cool, the body temperature rises and individuals may become ill.

Heat exhaustion occurs when the body gets too hot. It can be caused by physical exercise or hot weather. If an individual has heat exhaustion, they may experience:

  • Heavy sweating
  • Feeling weak and/or confused
  • Dizziness
  • Nausea
  • Headache
  • Fast heartbeat
  • Dark-colored urine, which is an indicator of dehydration

If you think you have heat exhaustion, you should get out of the heat quickly. Rest in a building with air-conditioning or find a cool and shady place. Drink plenty of water and other fluids. Do not drink alcohol or caffeinated drinks, because they can make heat exhaustion worse. Take a cool shower or bath and remove any tight or unnecessary clothing. If you don’t feel well in 30 minutes, contact a doctor. If heat exhaustion is not treated, it can progress to heatstroke.

Heat stroke is an abnormally elevated body temperature with accompanying physical symptoms including changes in the nervous system function. Heat stroke is a true medical emergency that is often fatal if not treated correctly. Infants, the elderly, athletes and those who physically exert themselves outside under the sun, are at the highest risk of heat stroke.

Symptoms of heat stroke can sometimes mimic those of heart attacks. Sometimes a person experiences symptoms of heat exhaustion before it progresses to heat stroke. Common symptoms and signs of heat stroke include:

  • High body temperature
  • Absence of sweating, with red or flushed dry skin
  • Rapid pulse
  • Difficulty breathing
  • Strange behavior
  • Hallucinations
  • Confusion
  • Agitation
  • Disorientation
  • Seizure
  • Coma

If you think someone might have heatstroke, call emergency medical personnel immediately! While waiting, take the person into an air-conditioned building or a cool, shady place. Remove unnecessary clothing to cool them down. Try to fan air over the person while wetting their skin with water. Appling ice packs to the person’s armpits, groin, neck and back can also help them cool down.

The best way to prevent heat illness is to stay in air-conditioned areas as much as possible on hot days. If you must go outside, here are several precautions to take to keep you safe:

  • Wear lightweight, light-colored, loose-fitting clothing.
  • Protect yourself from the sun with hats or umbrellas.
  • Use sunscreen with SPF 15 or more.
  • Drink plenty of water before starting an outdoor activity and continue to drink extra water throughout the day.
  • Drink fewer beverages that contain caffeine or alcohol.
  • Schedule activities before 10:00 a.m. and after 6:00 p.m. when the sun isn’t as strong.
  • During outdoor activities, take frequent breaks. Drink water or other fluids every 15 to 20 minutes.
  • If you have a chronic medical problem, ask your doctor how to deal with the heat, especially how your medications relate to heat.

For more information, visit www.FamilyDoctor.org, contact your health care provider or HealthLink Littauer at 736-1120. You can e-mail us at healthlink@nlh.org, see our website at nlh.org, or visit our wellness center at 213 Harrison Street Ext. in Johnstown, Monday – Friday, 9 a.m. – 5 p.m. We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.