iStockphoto/Thinkstock(NEW YORK) -- One more worry in the country's obesity crisis: a new documentary highlights the perils of extra pounds during pregnancy.

The TLC special, Obese & Expecting, follows four obese women through complicated pregnancies and painful deliveries that put mom and baby at risk.

"We know that obesity during pregnancy increases the risk of diabetes and preeclampsia," said Dr. Marjorie Greenfield, chief of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland. "And when the mom is big, the baby can be big, raising the risk of birth injury and C-section."

A scene from the documentary shows doctors struggling to give one woman an epidural through the fat in her back.

"We spent 45 minutes attempting to put the spinal in," said Dr. Charles Hux, a New Jersey OB/GYN featured in the documentary. "With so many layers of fat, it's difficult to be certain that the needle went into the exact space it should go in."

After several tries, the team gave up, deciding instead to give the woman a general anesthetic and a C-section.

"Going to sleep carries significant risks, even for a slim pregnant woman," said Greenfield, calling the decision a last resort. "And the risk goes up significantly in a woman who's overweight."

Studies suggest nearly half of U.S. women who are of child-bearing age are obese, a problem that weighs heavily on doctors.

"It's harder to provide excellent care to someone who's obese because a lot of things we do are not as accurate," said Greenfield, explaining how ultrasounds and other tests to gauge the baby's growth can be skewed by the mother's fat. "It's also harder to feel the position of the baby."

That fat, and the fact that obesity can cause irregular periods, also means women might not realize they're pregnant.

"If you don't know you're pregnant, you might not avoid things that are toxic, like alcohol, smoking and certain medications," said Greenfield, adding that prenatal vitamins are also important. "And a lot of what we do in prenatal care depends on knowing exactly how far along a woman is. If you don't have a sense of gestational age, it's harder to provide the right care."

Obesity has also forced hospitals to adapt, adding delivery tables that can be made wider and hold up to 600 pounds, Greenfield said.

"The old tables only went up to 450 pounds," she said. "That's just not realistic anymore."

Weight gain during pregnancy is normal. But obese women should gain no more than 15 pounds, roughly half the amount recommended for women of normal weight.

"For someone with bad eating habits, that's going to be really hard," said Greenfield, describing how pregnancy cravings and the "eating for two" mentality can conspire to pack on the pounds. "Lifestyle change is always hard. But during pregnancy, I think women are more motivated to do it for themselves and their baby."

Obese & Expecting premiered Thursday night at 9 p.m. on TLC.

Copyright 2012 ABC News Radio

Jupiterimages/Thinkstock(MIAMI) -- A man who elected to have a penile implant in a Florida hospital is now suing his doctor after a post-surgical infection resulted in the amputation of his organ.

Enrique Milla, 65, who was reportedly deported from the United States last year back to his native Peru, has been testifying in court via Skype that the medical procedure robbed him of his dignity and manhood.

In a medical malpractice trial that began this week, Milla claims that his doctors should have known that he was not a good candidate for the procedure because of his diabetes and high blood pressure.

"This has been devastating, painful and embarrassing," said Milla's attorney, Spencer Aronfeld of Coral Gables, according to ABC's affiliate WPLG.

Milla alleges that his anesthesiologist Dr. Laurentiu Boeru "failed to evaluate properly the risks of this procedure." He first filed the lawsuit in 2009, naming Boeru and Dr. Paul Perito, the urologist who performed the surgery.

According to the Miami Herald, which obtained records that are not publicly available, Perito settled the case out of court.

Penile implant surgery is most commonly performed after all other treatments for erectile dysfunction have failed. It is also used to treat some cases of Peyronie's disease, a condition that causes scarring inside the penis, leading to bent, painful erections.

Implant surgery comes with a risk of infection, which can occur at any time after surgery -- in rare cases, even years later, according to the Mayo Clinic.

Milla suffered from a number of medical conditions, including erectile dysfunction, according to court records. Milla, who had lived in Miami for 40 years working in a medical supply business, received the surgery in 2007 at Coral Gables Hospital. But two weeks after the operation, Milla developed an infection that eventually turned to gangrene. Amputation of his penis was necessary to save his life, according to his lawyer, who alleges Boeru didn't exercise proper care after the surgery.

"Post-operative period is about anywhere between six to 24 hours after surgery. It does not include either days or months," testified Boeru.

"This is an infection that occurred in this gentleman because he didn't do what he was supposed to do post-operatively nine days after the surgery," Boeru's lawyer Jay Chimpoulis, told WPLG.

He suggested that Milla ignored medical instructions to avoid sex and developed a fecal infection.

"There are any number of ways he could've gotten that. None of them had anything to do with [Boeru]," Chimpoulis said.

Dr. Pravin Rao, director of reproductive medicine and surgery at the Johns Hopkins Brady Urological Institute, said penile implants, called prostheses, are safe for patients who are in good health -- even those with diabetes, as long as the disease is "controlled." The risk rate is lower than three percent, according to Rao, who did not treat Milla.

Penile implants are among a "long algorithm of options" for those with erectile dysfunction, according to Rao. Urologists start with pills like Viagra -- the least invasive approach -- to vacuum erection devices and injection therapy. But sometimes those treatments fail because of the quality of the tissue in the penis or poor blood flow. The most common reason for ED is chronic disease that affects the vessels in the penis -- most often diabetes, hypertension, smoking or high cholesterol. Nerve damage, caused by spinal cord injuries, diabetes or radical prostate cancer surgery, can also trigger ED.

A poor candidate for a prosthesis is someone who is not in overall good health and may be at risk under anesthesia or not be able to withstand the blood loss of surgery.

"The number-one concern is infection, and that's why we make sure their overall health and immune status are good and their diabetes is under control," said Rao.

When infection does occur, the prosthesis must be immediately removed to clear the infection.

The prosthesis is an inflatable device that is inserted in the two tubes of the penis. The balloons can be filled up with fluid, creating an erection. A small pump is placed in the scrotum with a reservoir of fluid that connects to the tubing.

"When we first place it, we don't have it activated to create a full erection," said Rao. "Then after letting it heal for six weeks, [the patient] comes in and we teach them how to use the pump by squeezing it."

Patients are told not to have sex during that recuperative period.

Rao said that penile implants are "very successful and infection is not the norm."

Some studies of patients with diabetes and those without the disease had the same rate of infection. "But," he said, "we have to be prudent about picking the patient."
 
Copyright 2012 ABC News Radio

iStockphoto/Thinkstock(LA JOLLA, Calif.) -- “Cut back on calories” seems to be the dietary mantra when it comes to reducing weight.

However, a study on mice published Thursday in the Journal of Cell Metabolism suggests that losing weight may have less to do with watching calories — and more to do with watching the clock.

“For millions of years, we humans spent our lives as diurnal species — eating most of our calories only in the daytime and fasting overnight,” said Satchin Panda, associate professor at the Salk Institute for Biological Studies in La Jolla, Calif., and lead author on the study. “In the last one hundred years or so, we have started to stay up at night and consume calories at night too. During this time, we have also observed an increase in the cases of diabetes and obesity.”

This study found that mice that consumed as many calories as they wanted for eight hours and fasted for the remaining 16 hours were essentially the same as mice that ate a healthy diet when it came to gaining weight, diabetes risk and high cholesterol.

“The gist of this study is that the timing and the number of hours you fast impact your weight gain,” Panda said. “Watch the times of day you eat as opposed to what exactly you eat. You don’t have to be as strict in counting calories.”

So what does this mean for humans wanting to lose weight and reduce their risk for diabetes and high cholesterol? Dr. Darwin Deen, professor at City College of New York, said he is cautious of these findings as well as translating a study on mice to humans.

“In all of human history, there are more calories now to get fat with,” he said. “Now, when we wake up in the morning, the question isn’t, ‘Is there food to eat?’ but ‘What would you like to have for breakfast?’

“Perhaps the best conclusion from this study is eating at night is not the best idea and having a more regulated diet is something we need to aim for.”

Keith Ayoob, associate professor in the department of pediatrics at Albert Einstein College of Medicine, has similar thoughts. “Mice are mice. Humans work differently,” said Ayoob. “A high-calorie diet in eight hours can be a slippery slope; almost like a loaded gun.”  His advice?

Ayoob suggested eating a balanced diet — three meals a day with a snack. Breakfast eaters control their weight better than those who go for longer periods without eating and in turn, gain more weight. Additionally, he said, long-term weight management needs an activity component.

“Move! We focus a lot on food and diet, but activity is deal breaker.”

Dr. George Blackburn, associate director of the division of nutrition at Harvard Medical School, advises that developing a routine with a structured eating pattern is key. For example, it is important to eat breakfast because people are most active between breakfast and dinner, so calories are easily burned. The last meal should be eight to 10 hours after breakfast.

“This is a report that gives us one piece of knowledge that is valuable to us — have a time- restricted eating pattern that begins with breakfast,” Blackburn said.

Ultimately, Panda feels that this study shows that reducing the number of hours in which we eat and increasing the number of hours we fast can have significant effects on weight and risk for diabetes and high cholesterol.

“Over the last 50 years, we have come up with two lifestyle interventions for diabetes prevention — reduce caloric intake and increase exercise,” he said. “What we find today is that the calories in breakfast are different than the calories consumed in a midnight snack. Not all calories are created equal.”

Copyright 2012 ABC News Radio

Cultura/Getty Images(NEW YORK) -- A new survey shows 63 percent of Americans take a vitamin or supplement, but many wish the manufacturers would come up with a vitamin that would improve their significant other’s listening skills.

A survey commissioned by The Vitamin Shoppe finds 50 percent of respondents wish there was a pill that could improve their partner’s listening.  Forty-three percent wish there was a vitamin that would improve their significant other’s cleaning skills, while 31 percent expressed a desire for a vitamin that would improve their partner’s “bedroom” skills.

Respondents were asked: “If your significant other could take a vitamin to improve upon any of the following areas, which would you choose?

• Listening, 50 percent
• Cleaning, 43 percent
• Physique, 37 percent
• Cooking, 35 percent
• “Bedroom” Skills, 31 percent
• Dancing, 24 percent
• Don’t know/Refused, 20 percent

Additional findings from The Vitamin Shoppe survey:

• 93 percent of Americans feel more confident about their health when taking a vitamin or supplement.
• 72 percent of respondents take multivitamins on a regular basis.
• 56 percent believe vitamins and supplements are necessary to achieve your health and fitness goals.

Respondents were also asked: “What would put you in a better mood – good sex or a good workout?

• Good sex, 57 percent
• Good workout, 35 percent
• Don’t know/Refused, 8 percent

The Vitamin Shoppe survey of 1,000 U.S. adults was conducted by Wakefield Research.

Copyright 2012 ABC News Radio

Hemera/Thinkstock(NEW YORK) -- She's only eight, but Lacey-Mae Mason is already a beauty pageant veteran.  She competed in her first one when she was 14 months old.

But despite seven years of experience, the little girl from Brooklyn, Conn., faces perhaps her biggest pageant challenge yet in a nationwide competition chronicled on the upcoming season of TLC's show Toddlers & Tiaras.

What sets Lacey-Mae apart from the other little girls on the show is that she has achondroplasia, the most common type of dwarfism.  Although she's about twice as old, she is about as big as a three-and-a-half-year-old, said her mother, Kerry Ann Mason.

But judging from the mantle full of awards and trophies she's already won, her condition hasn't stopped her from wowing judges.

"Her size hasn't been an issue," said her mother.  "People notice there's something different about her, but I'm not sure it plays much of a role."

Toddlers & Tiaras has generated a lot of controversy, with critics accusing mothers of sexualizing their young children and pushing them to pint-sized perfection at any cost.  But Mason said she got Lacey-Mae involved in pageants to teach her daughter that she is beautiful no matter what her physical limitations may be.

"She entered her first pageant because they were handing out trophies just for participating," Mason said.  "I thought it would be great for her self-esteem to tell her one day that the trophy on her mantle was from a beauty pageant."

Child psychologists say the chance for children with disabilities to participate in the same activities as non-disabled children can be beneficial, as long as they are not exploited and actually want to participate.

"Any time you can give a kid a more normal experience, it's a good thing for kids and people in general," said Alan Hilfer, chief psychologist at Maimonides Medical Center in Brooklyn, N.Y.

While not endorsing the idea of child beauty pageants, Hilfer said including people whose appearance may not be considered normal can be a powerful teaching moment.

"This is a chance for this little girl to feel special with the spotlight of positive attention on her," said Fran Walfish, a child and family psychologist in Beverly Hills, Calif. and author of The Self-Aware Parent.  "This could really be helpful to her self-esteem."

But psychologists also said it's important for Lacey-Mae to be the one who really wants to compete.

"If she is feeling pressured to do it and other kids give her a hard time and tease her, it's not going to be good for her mental health," said Nadine Kaslow, professor and vice chair of Emory University's Department of Psychiatry.

Copyright 2012 ABC News Radio

Comstock/Thinkstock(HOUSTON) -- A vaccine may be able to keep an aggressive type of breast cancer from returning in women who have a history of the disease, according to early results of a new study. The vaccine still needs further research, but breast cancer experts say the results are promising.

Researchers at the MD Anderson Cancer Center in Houston developed a vaccine, called AE37, that trains the body's immune system to attack a common piece found on breast cancer tumors, a protein called HER2, which helps tumors grow.

"With this vaccine, we've educated the immune system to recognize this protein, HER2," said Dr. Elizabeth Mittendorf, the lead investigator on the trial. "If some rogue tumor cell is floating around, it can recognize it and take care of it before it can settle into bone or other parts of the body."

About 25 percent of breast cancer cases have an overactive amount of the HER2 protein, called HER2-positive breast cancer. This form of breast cancer is usually more aggressive and harder to treat than other types. But most tumors usually have some level of the protein, even if the amount is not enough to be classified as HER2-positive.

Mittendorf said one of the most encouraging things about the vaccine is that it seemed to reduce the risk of recurrent breast cancer in women who had both high and low levels of HER2, a group that accounts for about 70 percent of all breast cancer cases.

Mittendorf and her team studied 201 patients who had a history of breast cancer but who were disease-free at the time, giving the vaccine to about half of them. Based on the early outcomes of patients in the trial, the researchers projected that breast cancer would come back for 10.3 percent of the women who got the vaccine compared with 18 percent of the women who had not been vaccinated. That translates to a 43-percent reduced risk of recurrent breast cancer.

The study's results will be presented next month at a meeting of the American Society of Clinical Oncology.

Dr. Michele Zembo, 57, was one of the patients who got the vaccine. The pediatric orthopedic surgeon from New Orleans was diagnosed with breast cancer in October 2010 and after a year of chemotherapy, a mastectomy, radiation therapy and reconstructive surgery, she knew that her battle with breast cancer may not be over.

"That's just a reality of breast cancer. Somewhere down the line, there is that risk that it will come back," she said. "So you start wondering, what can I do to reduce my risk?"

She got regular exercise, changed her diet and even changed her high blood pressure medication when new evidence suggested beta blockers might reduce the risk of breast cancer. When her doctor told her about the clinical trial testing the AE37 vaccine, she did her research and decided to join the study.

Zembo said she experienced almost no side effects of the vaccine, just a minor rash and pain where the shots of the vaccine were injected. So far, Zembo said she is still free of breast cancer.

"I've tried to do everything that I can do to try to decrease my risk of recurrence. To me, this vaccine is one additional step, and a big step, that does that," Zembo said.

Breast cancer experts said the results of the study so far are promising, but they were cautiously optimistic. The number of patients in the study was relatively small, and they were monitored for less than a year. Women who have had breast cancer are at risk for recurrences for many years after their first diagnosis.

"We've seen a lot of treatments that have very early promise, but with follow-up studies just don't pan out, said Dr. Jay Brooks, chair of hematology and oncology at Ochsner Health System in New Orleans. "But it's interesting and something I would love to use in my practice if it proved successful."

The study is ongoing, and Mittendorf said it should finish in the fall of 2012. She hopes to launch a larger trial for the vaccine after that.

Mittendorf said the vaccine isn't useful for treating patients with advanced forms of the disease and isn't intended to replace other forms of treatment but to work in conjunction with them to fight breast cancer.

Copyright 2012 ABC News Radio

iStockphoto/Thinkstock(NASHVILLE, Tenn.) -- Patients prescribed the antibiotic azithromycin are more likely to die than those prescribed a different antibiotic, according to a study published in the New England Journal of Medicine on Wednesday. These results were especially pronounced for those who died from heart attacks, strokes, sudden cardiac death and other cardiovascular causes.

Azithromycin, commonly known by the trade name Z-Pak, is prescribed to almost 50 million Americans every year. Like the popular antibiotic amoxicillin, azithromycin is commonly prescribed to help fight off bacterial infections. But while they are often prescribed for similar conditions, the two drugs work differently from one another.

Wayne Ray, professor of preventive medicine at Vanderbilt University, in Nashville, Tenn., and lead author of the study, says he thinks many doctors prescribe azithromycin instead of amoxicillin because of its easier regimen; patients on azithromycin take fewer pills over fewer days, which means they are more likely to finish their entire course of medicine. Finishing the entire course not only leads to more effective treatment, but it also lessens the risk of the patient developing a drug-resistant bug.

But, Ray says of azithromycin, “the risk of death may outweigh convenience and compliance, at least for high-risk patients.”

These high-risk patients would seem to be those who have certain types of cardiovascular disease. Some doctors have suggested that azithromycin may cause irregular heartbeats known as arrhythmias, which in some people can lead to death. In Ray’s study, which looked at Medicaid patients from 1992 to 2006 and analyzed millions of prescriptions, he and his colleagues found that patients on azithromycin had two and a half times the odds of dying from a cardiovascular cause while taking their medication than did patients on amoxicillin. The gap was widest when looking at the 10 percent of patients with the worst cardiovascular disease.

The study wasn’t able to tease out which patients were on azithromycin because they had allergies to amoxicillin.

Cardiologist Leonard Ilkhanoff, director of the Inherited Arrhythmia Program at Northwestern University’s Feinberg School of Medicine, in Chicago, says that while it’s impossible to know what precisely is causing the increased risk of death, the study is very interesting. But he cautions that patients on azithromycin should not panic.

“Patients shouldn’t be thinking, ‘If I’m on azithromycin, I’m going to die,’” he says, adding that sometimes azithromycin really is the proper antibiotic for a patient.

“It’s appropriate, though, to discuss the risks and benefits with your doctor.”

Copyright 2012 ABC News Radio

ABC News(PROVIDENCE, R.I.) -- A 58-year-old woman paralyzed by a stroke was all smiles after sipping her cinnamon latte with the help of a mind-controlled robotic arm.

Cathy Hutchinson is one of two tetraplegic patients able to reach and grasp with a robotic limb linked to a tiny sensor in her brain, according to a study published Wednesday in the journal Nature. The device, called BrainGate, bypasses the nerve circuits broken by the brainstem stroke and replaces them with wires that run outside Hutchinson's body. The implanted sensor is about the size of a baby aspirin.

"You can go from the brain, which seems to be working quite well, directly to a device like a computer or a robotic arm," said BrianGate developer John Donoghue, director of the Institute for Brain Science at Brown University in Providence, R.I. "This can help restore independence to a person who was completely reliant on other people for every activity, whether it's brushing their teeth, eating their dinner or taking a drink."

Hutchinson, who has been unable to move or speak for 15 years, had the 96-channel sensor implanted in her brain's motor cortex in 2005. Since then, the BrainGate team has been fine-tuning the system to give her back some of the control she lost.

For most people, reaching and grasping is effortless. But the simple movement is guided by a complex pattern of brain activity, according to Donoghue.

With its hair-like electrodes, the BrainGate sensor taps into the flurry of brain activity, recording electrical signals that can be translated into movement commands. BrainGate also allows Hutchinson to move a computer cursor so she can communicate. But the device is not quite ready for prime time, Donoghue cautioned.

"Currently patients have a plug on their heads and need to be connected by to a cart full of electronics," he said. "We need to replace it with a wireless system."

Donoghue is collaborating with Arto Nurmikko, a neuroengineer at Brown, to do just that.

While the BrainGate system can currently control an external device, like a robotic arm, it could one day control a person's muscles.

Copyright 2012 ABC News Radio