“The cause of spina bifida is still unknown. Researchers believe it may be a combination of genetics and the environment that causes the condition. There are some things women who are pregnant or could get pregnant can do to help prevent spina bifida, including:

• Take at least 400 micrograms of folic acid each day. Spina bifida happens early in a pregnancy, often before a woman even knows she is pregnant. All women who are sexually active should take folic acid supplements. While taking folic acid and getting the best prenatal care cannot completely prevent spina bifida, it can reduce the risk.
• Talk with your primary care physician or pharmacist. If you’re planning to get pregnant or are sexually active, understanding how any prescriptions, over-the-counter medicines or supplements could affect a potential pregnancy can help you make decisions about your care.
• Work with your provider to monitor and manage your medical conditions. If you have a condition such as Type 1 or Type 2 diabetes or are overweight, you will want to work with your OB/GYN or primary care provider before getting pregnant. Once you are pregnant, your OB/GYN may refer you to a maternal-fetal medicine specialist to get extra care during your pregnancy.
• Avoid overheating your body (such as in a sauna or hot tub), and treat any fever you may have.”

NORTON Children’s (https://nortonchildrens.com/news/news-what-is-spina-bifida/)

  SPINA BIFIDA

TETHERED SPINALCORD (shown above)

FETUS WITH HYDROCEPHALUS (shown above)

  HYDROCEPHALUS

Spina Bifida is one of the causes of Tethered Spinal Cord and Hydrocephalus.

Tethered Spinal Cord is a stretch-induced functional disorder associated with the fixation (tethering) effect of inelastic tissue on the caudal spinal cord, limiting its movement. This abnormal attachment is associated with progressive stretching and increased tension of the spinal cord as a child ages, potentially resulting in a variety of neurological and other symptoms.

Hydrocephalus is caused by either increased production of CSF or impaired circulation and absorption

Spina bifida is a birth defect that affects the spine. Here are the latest national statistics on spina bifida in the United States:

1.)Each year, about 1,400 babies are born with spina bifida, or 1 in every 2,758 births, according to the U.S. Centers for Disease Control and Prevention. The exact cause of spina bifida is unknown. There is no cure but most people with spina bifida lead long and productive lives.

2.)Who it effects the most: Hispanic women have the highest rate of having a child affected by spina bifida, when compared with non-Hispanic white and non-Hispanic black women. Data from 12 state-based birth defects tracking programs were used to estimate the total number of pregnancies affected by spina bifida compared to the total number of live births (also called the prevalence of spina bifida) for each racial/ethnic group:

• Hispanic: 3.80 per 10,000 live births
• Non-Hispanic black or African-American: 2.73 per 10,000 live births
• Non-Hispanic white: 3.09 per 10,000 live births

The symptoms listed below are some of the ways in which tethered spinal cord syndrome may be exhibited in children:

• Lesion on the lower back
• Fatty tumor or deep dimple on the lower back
• Skin discoloration on the lower back
• Hairy patch on the lower back
• Back pain, worsened by activity and relieved with rest
• Leg pain, especially in the back of legs
• Leg numbness or tingling
• Changes in leg strength
• Progressive or repeated muscle contractions
• Bowel and bladder problems

Spina bifida consequences that may occur, know the type of the spina bifida gives an idea of how many problems the patient will have:

• Abnormal sensation or paralysis, which mostly occurs with closed neural tube defects and myelomeningocele.  People with these conditions typically have some degree of leg and core muscle weakness and loss of feeling in the groin and feet or legs.  The sensation can be more significant on one side of the body.
• You may see deterioration of the gait in the patient’s walking.  Typically, the lower in the spine where the condition occurs results in less weakness and loss of feeling.  The strength and feeling do not improve with age due to nerve damage.  People with these types of spina bifida may lose strength and sensation as they grow and mobility can become more difficult with age.  People with these conditions may walk independently or use some combination of leg braces, walkers, crutches, or wheelchairs.  As they age, they may require more of these supports.
• Chiari II malformation, in which parts of the brain called the brain stem and the cerebellum (hindbrain) protrude downward into the spinal canal or neck area.  It is almost always seen on advanced imagining of the brain in people with myelomeningocele, but it rarely causes symptoms.  When it does, this condition can press on the spinal cord and cause a variety of symptoms including difficulty breathing, swallowing, and arm weakness.  Surgery is sometimes required to reduce pressure in this area.
• Blockage of cerebrospinal fluid, causing a condition called hydrocephalus.  Hydrocephalus is the abnormal buildup of the fluid that surrounds the brain.  Most people with myelomeningocele have this condition, which is not seen in the other types of spina bifida.  This buildup can put damaging pressure on the brain.  Hydrocephalus is commonly treated by surgically implanting a shunt—a hollow tube—in the brain which allows drainage of the excess fluid into the abdomen where it is absorbed by the body.  The tube is tunneled under the skin and not very noticeable to others.  Another treatment option is an endoscopic third ventriculostomy or ETV, a procedure that creates a new path for the fluid to flow.
• Meningitis, an infection in the meninges covering the brain.  It can sometimes be associated with shunts.  Meningitis may cause brain injury and can be life-threatening.
• Tethered cord syndrome can occur with all forms of spina bifida, although it is very rare in individuals with spina bifida occulta.  Usually the spinal cord and nerves float freely.  A tethered cord means that there is some type of tissue attached to and pulling the cord down.  This can cause damage to the nerves and decrease feeling and strength, as well as problems with bowel and bladder control.  It is surgically treated if a person has symptoms.
• Bowel and bladder incontinence affect most individuals with myelomeningocele and closed neural tube defects.  The nerves at the very bottom of the spine control bowel and bladder function and don’t usually work properly in people with these types of spina bifida.  Most people with myelomeningocele and some types of closed neural tube defects need a regimen or other assistance to drain their bladders periodically or to have regularly scheduled bowel movements.
• Learning disabilities, including difficulty paying attention, understanding concepts, impaired motor skills, impaired memory, and difficulty with organization and problem solving are commonly seen in children with myelomeningocele.  People with strength lower down in their legs tend to have less difficulty than those with more leg weakness.  Evaluation for an individualized education plan is recommended for all children with myelomeningocele.
• Other complications such as skin ulcers, low bone mineral density, impaired male fertility, obesity, and kidney failure can be seen in people with myelomeningocele and neural tube defects as they age.  Additionally, people with myelomeningocele are at risk for precocious puberty (when changes to that of an adult occur too soon), sleep apnea, and depression.

The estimated lifetime cost of care for a person with spina bifida, with caregiving costs, is $791,900.

Learn tomorrow how you can prevent Spina Bifida with much more!

“October is Spina Bifida Awareness Month—a time to celebrate the hundreds of thousands of people living with Spina Bifida. Every October, we highlight community stories that challenge us to raise more awareness and support for those living with Spina Bifida.  As a community, we can do this by raising awareness about Spina Bifida either in our own circles or larger networks. It’s also a great time for us to challenge ourselves to find new ways to get involved in raising awareness and advocacy activities.

Spina Bifida is a birth defect that is something you are born with, its not something you develop over time.  There is no cure to Spina Bifida. ”

Spina Bifida Association (https://www.spinabifidaassociation.org/awareness-month/)

“If longevity runs in your family, you have a better chance of living longer. But genetics is only part of the equation: the lifestyle choices you make play a big role in living longer, staying healthy, and being able to continue doing the things you love.

Longevity simply refers to long life. In the U.S., life expectancy has increased dramatically since 1900, when the average lifespan was 47 years. Today, people born in 2022 can expect to live 77.5 years.

Experts estimate that about 25% of the variation in human life span is determined by genetics. But the rest can be attributed in large part to how we take care of our bodies.

There are simple things you can do to be your healthiest, most active, most productive self while living longer. The keys to perhaps living to age 100 or more are a healthy diet, regular physical activity, and good lifestyle choices.”

Harvard Health Publishing (https://www.health.harvard.edu/staying-healthy/longevity-lifestyle-strategies-for-living-a-healthy-long-life)

We live for generations relying more on treatment versus prevention (secondary versus primary care).  Yes we have drastically improved in the health care system leaning more to primary through further research and technology.  Also, we have advanced in practicing prevention to some degree; that would be regarding certain illnesses/disease but the society in our nation is still too high on being the ones relying on treatment rather than prevention.  Adults alone are 65% obese which is a main cause for certain diseases remaining on the rise in this country.  These diseases are still on the rise due to some of our cultural eating habits in our homes.  For American culture that includes the restaurant industry and social acceptance of the do’s and don’ts in our communities.  Out of homes in America we are exposed to fast foods, lack of allowing kids to play in a baseball fields with safe/ responsible adults because they don’t have a permit, no desire to be active due to being in the computer too many hours or even watching TV instead of 30 to 60 minutes of exercise squeezed in our daily schedules somewhere.  Due to this behavior we inflict on ourselves either increasing risks of or the cause of or worsening of diseases or illnesses in American citizens or any citizen in some country who lives the same life style; ending line its due to the diet or the poor health habits practiced in the individual’s life.  If you and others knew in our country the baby steps in becoming healthier NOW not tomorrow it would benefit your health and your life line extending it dramatically, especially if you start in your younger years with no illness/disease or very little.  You’ve heard the line I’ll start next month with next month never happening or this will be my New Year’s resolution on Christmas and it’s already forgotten on Jan. 1st.  Unfortunately a lot end up with the poor health due to their sedentary life style being their diet and poor healthy habits.  Don’t put it off anymore, take the first step, and increase the changes you need to a better mind and body.  Join me with others in learning healthy habits.   Prevent the following diseases that obesity alone can cause, which are: 

1. High Blood Pressure–High blood pressure is the primary cause of death among Americans older than 25. About 75 million people suffer from high blood pressure or hypertension, which is a major risk factor for heart disease. Blood pressure tends to increase with weight gain and age. It is not known why obesity is a major cause of high blood pressure. However, research has shown that obese patients displayed an increase in blood volume and arterial resistance causing more stress to the heart. For people who are overweight and have high blood pressure, losing as little as 8 pounds can help reduce blood pressure to a safe level.
2. Diabetes–Obesity is considered one of the most significant factors in the development of insulin resistance, and insulin resistance can lead to type 2 diabetes. According to the World Health Organization, more than 90 percent of diabetes patients worldwide have type 2 diabetes. Being overweight or obese contributes to the development of diabetes by making cells more resistant to the effects of insulin. A weight loss of 15-20 pounds can help you decrease your risk of developing type 2 diabetes 
3. Heart Disease — According to the American Heart Association, obesity is a major risk factor for developing coronary heart disease, which can lead to a heart attack or stroke. People who are overweight are at a greater risk of suffering a heart attack before the age of 45.  Obese adolescents have a greater chance of having a heart attack before the age of 35 than non-obese adolescents. If you are overweight, losing 10-15 pounds can reduce your risk of developing heart disease. If you exercise regularly, the risk of developing heart disease falls even more.
4. High Cholesterol levels — High cholesterol is one of the leading causes of heart attacks. Cholesterol is transported through your blood in two ways: the low density lipoprotein (LDL), which transports cholesterol to the cells that need it, and the high density lipoprotein (HDL), which is the healthy cholesterol that reduces your risk for heart attack. Having high LDL levels raises your risk of having heart disease by 20 percent. Losing 11-20 pounds can help you significantly reduce your cholesterol level.
5. Cancer — A study by the American Heart Association found that being overweight increases your chances for developing cancer by 50 percent. Women have a higher risk of developing cancer if they are more than 20 pounds overweight. Regular exercise and a weight loss of as little as 12 pounds can significantly decrease the risk.
6. Infertility — Being obese can cause changes in the hormonal levels of women, which can result in ovarian failure. Women who are 15-25 pounds overweight are at a higher risk of suffering from infertility and ovarian cancer. Our bodies need to be at an appropriate weight to produce the right amount of hormones and regulate ovulation and menstruation. Don’t think men are immune to infertility. Overweight men have a greater chance of developing motility and a lower sperm count. Shedding 12-14 pounds can help you lower the risks.
7. Back Pain — Obesity is one the contributing factors of back and joint pain. Excessive weight can cause injury to the most vulnerable parts of the spine, which carries the body’s weight. When it has to carry excess weight, the odds of suffering from a spinal injury or structural damage increase. Being overweight also raises the risk of developing osteoporosis, lower back pain, arthritis, and osteoarthritis. Losing 10-15 pounds can help you decrease the risk of developing these problems.
8. Skin Ulcers & leading to infected ulcers — Obese and overweight individuals may have skin that folds over on itself. These creased areas can become irritated from the rubbing and sweating, which can cause alteration in the skin from a rash first forming to an actual ulcer of the skin occuring that can lead to ulcer skin infections (local infections) that can go further into systemic infections (which is an infection throughout the circulatory system).
9. Gastric Ulcers — According to a study by the National Institutes of Health (NIH), obesity can be a contributing factor to the development of gastric ulcers. Gastric ulcers occur when there is an imbalance between the amount of hydrochloric acid that is secreted and the enzyme pepsin. Overweight men are at a greater risk of developing gastric ulcers than women. A weight loss of as little as 7 pounds can help reduce the risk.
10. Gallstones — Being severely overweight increases the risk of developing gallstones, especially in women. Gallstones are caused when the liver releases excessive amounts of bile, which is stored in the gallbladder. Gallstones are more common in older women and those with a family history of gallstones. Losing 4-9 pounds reduces the risk of developing gallstones. Moderate exercise also can help lower your risk.

If you suffer from type 2 diabetes or pre-diabetes, cardiac disease including high blood pressure or cholesterol and need to lose weight I can help you manage the disease through nutrition and fitness education including behavior modification.  You will  learn healthy habits that will help you lose weight through Dr. Anderson and many other references in books or on the net .  Take the right step in moving towards a healthier, happier and even longer lifestyle.   I hope you like myself and so many others take the step in reaching a healthier body and spread the news to make America overall a healthier country.  It is recommended anyone with a disease or illness to first check with your doctor for clearance before doing any diet or activity changes you plan to add to your life to prevent injury.

References

American Heart Association, National Institutes of Health, mediweightlossclinics.com and the Centers for Disease Control and Prevention.

“Yersinia enterocolitica is a gram-negative bacillus shaped bacterium that causes a zoonotic disease called yersiniosis. The infection is manifested as acute diarrhea, mesenteric adenitis, terminal ileitis, and pseudoappendicitis. In rare cases, it can even cause sepsis.Infection is transferred predominantly through the fecal-oral route. Pork consumption especially undercooked or raw pork products are responsible for yersiniosis.”

National Library of Medicine (https://www.ncbi.nlm.nih.gov/books/NBK499837/)

Yersiniosis is an infection caused most often by eating raw or undercooked pork contaminated with Yersinia enterocolitica bacteria. CDC estimates Y. enterocolitica causes almost 117,000 illnesses, 640 hospitalizations, and 35 deaths in the United States every year. Children are infected more often than adults, and the infection is more common in the winter.

Yersinia are bacteria that can cause illnesses in humans.

Yersiniosis refers to the illnesses caused by Y. enterocolitica and less often by Y. pseudotuberculosis infections.

Y. enterolitica are the most common species causing human enteric (intestinal) yersiniosis.

Pigs are the major animal reservoir for the few strains of Y. enterocolitica that cause human illness, but rodents, rabbits, sheep, cattle, horses, dogs, and cats also can carry strains that cause human illness.

The Symptoms:

The symptoms of yersiniosis depend on the age of the person infected. Infection occurs most often in young children. Common symptoms in children are fever, abdominal pain, and diarrhea, which is often bloody. Symptoms typically develop 4 to 7 days after exposure and may last 1 to 3 weeks or longer. In older children and adults, right-sided abdominal pain and fever may be the predominant symptoms and may be confused with appendicitis. Complications are rare, and may include skin rash, joint pains, or spread of bacteria to the bloodstream.

CDC estimates that infections with Yersinia enterocolitica cause almost 117,000 illnesses, 640 hospitalizations, and 35 deaths in the United States every year. Children are infected more often than adults, and the infection is more common in the winter.

How Humans get this illness:

Most people become infected by eating contaminated food, especially raw or undercooked pork, or through contact with a person who has prepared a pork product, such as chitlins. For example, babies and infants can be infected if their caretakers handle contaminated food and then do not wash their hands properly before handling the child or the child’s toys, bottles, or pacifiers.

People occasionally become infected after drinking contaminated milk or untreated water, or after contact with infected animals or their feces.

On rare occasions, people become infected through person-to-person contact. For example, caretakers can become infected if they do not wash their hands properly after changing the diaper of a child with yersiniosis.

Even more rarely, people may become infected through contaminated blood during a transfusion.

How this illness is diagnosed:

Yersiniosis usually is diagnosed by detecting the bacteria in the stool of an infected person. Many laboratories do not routinely test for Yersinia, so it is important that the clinician notifies the laboratory when yersiniosis is suspected so that special tests can be done.

The long-term consequences of yersiniosis:

Most symptoms go away completely. However, some people may experience the following:

• Joint pain, called reactive arthritis, most commonly in the knees, ankles, or wrists. These joint pains usually develop about 1 month after yersiniosis illness begins and generally go away after 1 to 6 months.
• A skin rash, called “erythema nodosum,” on the legs and torso. The rash is more common in women and usually goes away within a month.

How you can protect yourself and the family from this infection?

• Avoid eating raw or undercooked pork.
• Consume only pasteurized milk and milk products, such as soft cheese, ice cream, and yogurt.
• Wash hands thoroughly with soap and water before eating and preparing food, especially touching raw meat.
• After handling raw chitlins, clean hands and fingernails carefully with soap and water before touching infants or their toys, bottles, or pacifiers. Someone other than the person handling food should care for children while chitlins are being prepared.
• Prevent cross-contamination in the kitchen by using one cutting board for raw meat and another cutting board for fresh produce. Carefully clean all cutting boards, countertops, and utensils with soap and hot water after preparing raw meat.
• Dispose of animal feces (poop) in a sanitary manner.

Treatment:

1-Care in patients with this illness infection is primarily supportive, with good nutrition and hydration being mainstays of treatment.

2-First-line drugs used against the bacterium include aminoglycosides and trimethoprim-sulfamethoxazole (TMP-SMZ). Other effective drugs include third-generation cephalosporins, tetracyclines (not recommended in children under 8 y), and fluoroquinolones (not approved for use in children under 18 y).

“Tuberculosis (TB) germs spread through the air from one person to another.

TB germs can get into the air when someone with active TB disease coughs, speaks, or sings.

People nearby may breathe in these germs and become infected.

People with inactive TB, also called latent TB infection, cannot spread TB germs to other”

Centers for Disease Control and Prevention – CDC (https://www.cdc.gov/tb/causes/index.html)

How does PTB develop? TB bacilli enters the body and lodges in the lungs (TB Infection). In the lungs, they multiply and slowly eat the cells and the body begins to experience symptoms (TB Disease)  A person who develops a TB disease, when remain untreated, can then begin to infect others. In some cases, the TB germ migrates to other body organs and begin to destroy them, thus the advent of extra-pulmonary (outside) cases of Tuberculosis like TB of the meninges, bones, etc. A TB disease that remains untreated leads to death.

Airborne to prevent the transmission of highly contagious or virulent infections spread by small airborne droplets (smaller than 5 microns) examples know or suspected TB, chicken pox.

Airborne Precautions: spread of microbes on small droplet nuclei through the air ( 5 microns); which transmit 3 feet in air. (ie) TB, Mumps; Pertussis; Influenza; SARS. Private room / or cohort clients, and mask worn if within 3 feet.

TB can be transmitted in just about any setting. It can be spread in places such as homes or worksites. However, TB is most likely to be transmitted in health care settings when health care workers and patients come in contact with persons who have unsuspected TB disease, who are not receiving adequate treatment, and who have not been isolated from others. All health-care settings need an infection-control program designed to ensure the following:

• Prompt detection of TB disease;
• Airborne precautions; and
• Treatment of people who have suspected or confirmed tuberculosis (TB) disease.

Overview of TB Infection-Control Measures

The TB infection-control program should be based on the following three-level hierarchy of control measures:

1. Administrative controls
2. Environmental controls
3. Use of respiratory protective equipment

Administrative Controls

The first and most important level of the hierarchy, administrative controls, are management measures that are intended to reduce the risk or exposure to persons with infectious TB.  These control measures consist of the following activities:

• Assigning someone the responsibility for TB infection control in the health care setting;
• Conducting a TB risk assessment of the setting;
• Developing and implementing a written TB infection-control plan;
• Ensuring the availability of recommended laboratory processing, testing, and reporting of results;
• Implementing effective work practices for managing patients who may have TB disease;
• Ensuring proper cleaning, sterilization, or disinfection of equipment that might be contaminated (e.g., endoscopes);
• Educating, training, and counseling health care workers, patients, and visitors about TB infection and disease;
• Testing and evaluating workers who are at risk for exposure to TB disease;
• Applying epidemiology-based prevention principles, including the use of setting-related TB infection-control data;
• Using posters and signs to remind patients and staff of proper cough etiquette (covering mouth when coughing) and respiratory hygiene; and
• Coordinating efforts between local or state health departments and high-risk health-care and congregate settings.

Environmental Controls

The second level of the hierarchy is the use of environmental controls to prevent the spread and reduce the concentration of infectious droplet nuclei.  This includes two types of environmental control.

• Primary environmental controls consist of controlling the source of infection by using local exhaust ventilation (e.g., hoods, tents, or booths) and diluting and removing contaminated air by using general ventilation.
• Secondary environmental controls consist of controlling the airflow to prevent contamination of air in areas adjacent to the source airborne infection isolation (AII) rooms; and cleaning the air by using high efficiency particulate air (HEPA) filtration, or ultraviolet germicidal irradiation.

Respiratory Controls

The third level of the hierarchy is the use of respiratory-protection control. It consists of the use of personal protective equipment in situations that pose a high risk of exposure to TB disease.

Use of respiratory protection equipment can further reduce risk for exposure of health care workers to infectious droplet nuclei that have been expelled into the air from a patient with infectious TB disease. The following measures can be taken to reduce the risk for exposure:

• Implementing a respiratory protection program;
• Training health care workers on respiratory protection; and
• Educating patients on respiratory hygiene and the importance of cough etiquette procedures.

Determining the Infectiousness of TB Patients

The infectiousness of a TB patient is directly related to the number of droplet nuclei carrying M. tuberculosis (tubercle bacilli) that are expelled into the air.  The number of tubercle bacilli expelled by a TB patient depends on the following factors:

• Presence of a cough
• Cavity in the lung
• Acid-fast bacilli on sputum smear
• TB disease of the lungs, airway, or larynx
• Patient not covering mouth and nose when coughing
• Not receiving adequate treatment or having prolonged illness
• Undergoing cough-inducing procedures
• Positive sputum cultures

Patients can be considered noninfectious when they meet all of the following three criteria:

• They have three consecutive negative AFB sputum smears collected in 8- to 24-hour intervals (one should be an early morning specimen);
• They are compliant with an adequate treatment regimen for two weeks or longer; and
• Their symptoms have improved clinically (for example, they are coughing less and they no longer have a fever).