In November 2012, the U.S. Food and Drug Administration (FDA) approved XELJANZ® (tofacitinib citrate) 5 mg tablets for the treatment of adults with moderately to severely active RA who have had an inadequate response or intolerance to methotrexate. XELJANZ may be used as monotherapy or in combination with methotrexate or other non-biologic disease-modifying antirheumatic drugs (DMARDs). XELJANZ should not be used in combination with biologic DMARDs or with potent immunosuppressives, such as azathioprine and cyclosporine.

Although multiple treatments are available for RA, there is a need for additional options. Up to one-third of patients do not adequately respond to treatment, and about half stop responding to any particular DMARD within five years.

“XELJANZ, the first oral DMARD approved for RA in more than 10 years, offers an additional treatment option for people with RA and for the doctors who treat it,” said Dr. Mark Genovese, MD, Professor of Medicine, Stanford University Immunology & Rheumatology Division. “In some clinical trials for RA, XELJANZ was effective in relieving signs and symptoms and in improving physical function. I am glad to have an additional option to offer my patients with moderately to severely active RA.”

XELJANZ is the first approved RA medicine in a new class of drugs known as Janus kinase (JAK) inhibitors. JAKs are proteins inside cells that influence the immune system by sending signals through a pathway. XELJANZ inhibits the JAK pathways. It has a novel mechanism of action and is in the form of a pill.

The approval of XELJANZ is based on clinical trial data from approximately 5,000 patients with 7,000 patient-years of exposure.

Safety findings observed in the overall XELJANZ RA program include serious and other important infections, including tuberculosis and herpes zoster; malignancies, including lymphoma; gastrointestinal perforations; decreased neutrophil and lymphocyte counts; decreased hemoglobin; liver enzyme elevations; and lipid elevations.

The most common serious adverse events were serious infections. The most commonly reported adverse events were upper respiratory tract infections, headache, diarrhea and nasopharyngitis.

With the approval of XELJANZ, Pfizer has also developed XELSOURCE, a patient assistance resource, which provides information about access and coverage for XELJANZ. To learn more about XELSOURCE, visit XELJANZ.com or call 1-855-4-XELJANZ (1-855-493-5526).

For full prescribing information, including boxed warning and Medication Guide, please visit www.XELJANZ.com.

What is XELJANZ?

XELJANZ is a prescription medicine called a Janus kinase (JAK) inhibitor.

XELJANZ is used to treat adults with moderately to severely active rheumatoid arthritis in which methotrexate did not work well.

It is not known if XELJANZ is safe and effective in people with Hepatitis B or C.

XELJANZ is not for people with severe liver problems.

It is not known if XELJANZ is safe and effective in children.

Important Safety Information

What is the most important information I should know about XELJANZ?

XELJANZ may cause serious side effects including:

Serious infections. XELJANZ can lower the ability of your immune system to fight infections. Some people have serious infections while taking XELJANZ, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting XELJANZ, and monitor you closely for signs and symptoms of TB infection during treatment. You should not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay.

Before starting XELJANZ, tell your healthcare provider if you:

think you have an infection or have symptoms of an infection such as fever, sweating, or chills; muscle aches; cough; shortness of breath; blood in phlegm; weight loss; warm, red, or painful skin or sores on your body; diarrhea or stomach pain; burning when you urinate or urinating more often than normal; or feeling very tiredare being treated for an infectionget a lot of infections or have infections that keep coming backhave diabetes, HIV, or a weak immune system. People with these conditions have a higher chance for infections.have TB, or have been in close contact with someone with TBlive or have lived in, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis). These infections may happen or become more severe if you use XELJANZ. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common.have or have had hepatitis B or C
After starting XELJANZ, call your healthcare provider right away if you have any symptoms of an infection. XELJANZ can make you more likely to get infections or make worse any infection that you have.

Cancer and immune system problems. XELJANZ may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers can happen in patients taking XELJANZ. Tell your healthcare provider if you have ever had any type of cancer.

Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr Virus-associated post transplant lymphoproliferative disorder).

Tears (perforation) in the stomach or intestines. Some people taking XELJANZ get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate. Tell your healthcare provider right away if you have fever and stomach-area pain that does not go away, and a change in your bowel habits.

Changes in certain lab test results. Your healthcare provider should do blood tests before you start receiving XELJANZ, and while you take XELJANZ to check for the following side effects:

changes in lymphocyte counts. Lymphocytes are white blood cells that help the body fight off infections.low neutrophil counts. Neutrophils are white blood cells that help the body fight off infections.low red blood cell count. This may mean that you have anemia, which may make you feel weak and tired.

Your healthcare provider should routinely check certain liver tests.

You should not receive XELJANZ if your lymphocyte count, neutrophil count, or red blood cell count is too low or your liver tests are too high. Your healthcare provider may stop your XELJANZ treatment for a period of time if needed because of changes in these blood test results.

Your healthcare provider should do blood tests to check your cholesterol levels 4-8 weeks after you start XELJANZ, and as needed after that.

For full prescribing information, including boxed warning and Medication Guide, please visit www.XELJANZ.com.

The post Another Treatment Option for Patients with Rheumatoid Arthritis appeared first on NJ Top Doctors Blog.

Life-threatening allergic reactions may occur as a result of exposure to allergens including foods such as peanuts, tree nuts, fish, shellfish, dairy, eggs, soy and wheat; insect stings; latex and medication, among other allergens and causes. Outdoor celebrations can pose challenges for people living with severe allergies. Picnics, for example, bring together large groups of people and often a smorgasbord of food. This can be dangerous for those with severe food allergies, as even the smallest amount of an ingredient or cross-contamination with another food can trigger a severe allergic reaction. Eating outside can also attract stubborn insects whose stings may be unpredictable.

Dr. Vivian Hernandez-Trujillo, a pediatric allergist, national expert in anaphylaxis and consultant to Sanofi US, says the best way to prevent anaphylaxis is to avoid the specific allergen(s). However, because severe allergic reactions can be unexpected, it’s critical to always carry an epinephrine auto-injector, such as Auvi-Q™ (epinephrine injection, USP), in case emergency treatment is needed. “I always stress to my patients how important it is to carry an epinephrine auto-injector at all times, in addition to allergen avoidance,” said Dr. Hernandez-Trujillo.

While guidelines emphasize the importance of the life-saving role of epinephrine, two large surveys (n=600 and n=651) show that two-thirds of patients and caregivers do not carry their epinephrine auto-injectors as recommended, and nearly half worry that others will not know how to use their or their child’s epinephrine auto-injector correctly during an emergency.

Those at risk for severe allergic reactions should speak with their healthcare provider about treatment options. Auvi-Q is one option for the emergency treatment of life-threatening allergic reactions in people who are at risk for or have a history of anaphylaxis. The size and shape of a credit card and the thickness of a smartphone, Auvi-Q is a breakthrough in epinephrine auto-injector design with audio and visual cues that guide patients and caregivers step-by-step through the injection process.

In addition to always carrying an epinephrine auto-injector such as Auvi-Q, here-are some tips to help stay safe outdoors and enjoy the coming months:

Picnic/Barbecue Need-to-Knows

Make everyone aware of your or your child’s severe allergiesConsider making homemade food rather than store-bought or take-out, as these foods may contain hidden allergensSingle-serve condiment packets can help avoid cross-contaminationTablecloths can help protect against anything left on the table from previous mealsUse foil when grilling food to avoid past contaminantsLook for non-latex balloon alternatives, such as mylar balloons, for celebration needs

Tips to Avoid Stinging Insects

Keep food and drink, especially sweets, covered to avoid attracting stinging insectsDon’t swat at bees. Walk away slowly, instead.Wearing close-fitting long sleeves and pants or insect repellent can reduce the risk of getting stungBees and wasps look for food among flowers, plants and garbage, so beware of these areas

Indication

Auvi-Q™ (epinephrine injection, USP) is used to treat life-threatening allergic reactions (anaphylaxis) in people who are at risk for or have a history of these reactions.

Important Safety Information

Auvi-Q is for immediate self (or caregiver) administration and does not take the place of emergency medical care. Seek immediate medical treatment after use. Each Auvi-Q contains a single dose of epinephrine.-Auvi-Q should only be injected into your outer thigh.-DO NOT INJECT INTO BUTTOCK OR INTRAVENOUSLY. If you accidentally inject Auvi-Q into any other part of your body, seek immediate medical treatment. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heart-related (cardiac) symptoms.

If you take certain medicines, you may develop serious life-threatening side effects from epinephrine.-Be sure to tell your doctor all the medicines you take, especially medicines for asthma. Side effects may be increased in patients with certain medical conditions, or who take certain medicines. These include asthma, allergies, depression, thyroid disease, Parkinson’s disease, diabetes, high blood pressure, and heart disease.

The most common side effects may include increase in heart rate, stronger or irregular heartbeat, sweating, nausea and vomiting, difficulty breathing, paleness, dizziness, weakness or shakiness, headache, apprehension, nervousness, or anxiety. These side effects go away quickly, especially if you rest.

Talk to your healthcare professional to see if Auvi-Q is right for you.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit-www.fda.gov/medwatch-or call 1-800-FDA-1088.

Please visit http://products.sanofi.us/auvi-q/auvi-q.html for full prescribing information.

For additional information and updates, please be sure to also visit and “like” Sanofi US’ Severe Allergy Awareness Facebook page at www.facebook.com/severeallergyawareness.

To learn more about Auvi-Q visit www.Auvi-Q.com.

The post Summer Tips for Those at Risk for Anaphylaxis appeared first on NJ Top Doctors Blog.

Severe vision loss is a reality for people with age-related macular degeneration (AMD), a disease of the retina that affects more than 9.1 million people in the United States. What is it like to have AMD? The disease robs people of their central vision and leaves only what they can see in their peripheral vision, making it incredibly difficult to use vision for even the simplest activities. AMD’s most advanced form – end-stage AMD – is the leading cause of irreversible vision loss and legal blindness in people age 60 and older.

For retired entrepreneur, Willis “James” Hindman, 77, of Westminster, Md., the losses he faced from end-stage AMD were both physical and emotional. Hindman’s passions are his family, friends and the horses that he raises on his farm. AMD destroyed his vision to the point where he couldn’t see people’s faces or watch his race horses cross the finish line. He felt he was a prisoner of his own limitations and quickly became depressed.

Hindman isn’t alone; as the baby boomer population continues to grow, the occurrence of AMD is likely to grow with it. According to the U.S. Census Bureau, the baby boomer population will increase to 72 million by 2030, placing roughly 20 percent of the U.S. population at risk for AMD.

At this time, there is no cure for AMD and no way to reverse its effects, although there are advanced treatments, including medication injections, laser surgery, and what is most recently getting attention, an FDA-approved telescope implant, that has been clinically demonstrated to improve vision and quality of life for patients living with this debilitating disease.

“The telescope implant surgical procedure removes the eye’s natural lens, and replaces it with a tiny telescope, about the size of a pea,” explains Dr. Mark Mannis, Professor and Chair at University of California, Davis Department of Ophthalmology. “It may sound like science fiction, but it is available to patients today. The telescope is implanted in one eye to improve central vision, something no other surgery can do for patients with AMD. The other eye will continue to provide peripheral vision, which is important to maintain orientation and balance.”

The telescope implant is integral to a new patient care program, CentraSight. The CentraSight treatment program has been designed to help patients see the things that are important to them, regain independence and re-engage in everyday activities. The program uses a multispecialty eye and vision care team to follow the necessary steps for proper diagnosis, surgical evaluation, and postoperative care.

While the telescope implant does not fully restore vision to its pre-AMD level, it will help the patient enjoy better sight and quality of life following an individualized rehabilitation process, where the patient learns exactly how to use the new telescope implant vision for everyday activities. Hindman had his surgery in December 2012 and today feels he has “a new lease on life.” Working with his low-vision occupational therapist, he practices strengthening his eye with standard vision exercises, but also incorporates personalized, fun activities, like watching his fishing lure bob in the water.

Now Hindman also watches football from across the room, walks to his local office without counting steps and, most gratifyingly, sees the faces of his loved ones, including his horses.

The telescope implant is available at more than 50 CentraSight treatment centers nationwide. Of note, the telescope implant is also Medicare eligible, making it within reach of most seniors. To be considered potential candidates, patients must:

1. Have irreversible, end-stage AMD resulting from either dry or wet AMD
2. No longer be a candidate for drug treatment of your AMD
3. Have not had cataract surgery in the eye in which the telescope will be implanted
4. Meet age, vision and corneal health requirements

“After learning how to use the telescope, patients may enjoy better sight so they can do the things they love again like reading, knitting, gardening, walking outside and simply recognizing the faces of family and friends,” says Dr.- Mannis.

Patients can talk to their ophthalmologist to see if this procedure is right for them. Visit www.CentraSight.com or call toll-free 877-99-SIGHT (1-877-947-4448) to determine if you or a loved one suffering from AMD is a potential candidate for the procedure

The post Science fiction is now science fact: There’s hope for aging eyes with macular degeneration appeared first on NJ Top Doctors Blog.

According to the US Census Bureau, the population of adults over age 65 is expected to double by 2025, and the American Optometric Association (AOA) reports that the incidence of Age-Related Macular Degeneration (AMD) is expected to triple during the same time period.

In 2010, more than 10 million people were affected by AMD, and looking even further into the future, that number is expected to jump 150 percent by 2050, based on the National Eye Institute’s (NEI) Projections for AMD.

The leading cause of severe vision loss in people over age 50, AMD damages the macula (center of the retina) and as the disease progresses, it blurs one’s central vision. AMD presents in two forms, wet and dry. Dry AMD is more common, and occurs when the visual cells in the macula slowly break down. Dry AMD that goes untreated can progress to wet AMD-caused by the abnormal growth of blood vessels under the macula. Wet AMD-is considered advanced AMD and-can lead to rapid loss of central vision,-which is-typically more severe than the dry form.

The NEI recently released the results of AREDS 2 (Age-Related Eye Disease Study 2), a five-year, 4,203 patient study of people between 50 and 85 years of age with intermediate AMD in both eyes, or advanced AMD in one eye.

The objective of the AREDS 2 Study was to determine if the addition of Zeaxanthin, Lutein, and Omega 3′s to the original AREDS formula would further reduce the progression to advanced AMD. Numerous clinical studies suggest these nutrients protect vision.

The original AREDS study results were released in 2001, and revealed that high-dose antioxidant vitamins and minerals including Vitamins C and E, Beta-Carotene, Zinc, and Copper reduced the risk of progression to advanced AMD by 25 percent, and the risk of moderate vision loss by 19 percent.

By adding Zeaxanthin (zee-uh-zan-thin) and Lutein to the original AREDS nutrients, study results demonstrated that the progression to advanced AMD was reduced by 9 percent when compared with no lutein and zeaxanthin, and an 18 percent reduction in progression to advanced AMD in subjects who received the AREDS supplement with lutein and zeaxanthin versus the original AREDS supplement with beta carotene.

Another important take-away from the AREDS 2 Study, which applies to most Americans, was a 26 percent reduction in progression to advanced AMD for subjects with the lowest dietary intake of-lutein and zeaxanthin. In the US, dietary intake of–lutein and zeaxanthin is typically less than 1 mg per day – well below the 10 mg of lutein and 2 mg of zeaxanthin in the AREDS 2 Study.

A superior photo-protector and antioxidant, Zeaxanthin protects the cones in the eye which are responsible for our central vision. Lutein, the other predominant macular pigment, protects the rods in the eye, which are responsible for our peripheral vision. Both of these macular pigments act like internal sunglasses to protect and enhance vision.

The AREDS 2 Study also included supplementation of the Omega-3 fatty acids, DHA and EPA. While Omega-3s did not prove beneficial in slowing the progression to advanced AMD, DHA is a major component of the retina, and both EPA and DHA have been identified as important compounds to support eye health, heart health, and other organ systems.- -

Finally, in the original AREDS study, approximately two thirds of the subjects also took a multi-vitamin daily, and 90 percent of subjects in the AREDS 2 Study consumed a multi-vitamin. Multi-vitamins contain other essential ingredients that benefit eye and overall health.

The AREDS 2 Study demonstrates that AMD progression can be slowed through eye vitamin consumption, and many other clinical studies confirm that healthy macular pigment density protects and enhances vision. Eye vitamin brands like EyePromise feature optimal levels of these protective macular pigments along with other natural nutrients essential for ocular health.

Consult your Eye Care Professional about age-related eye disease and the importance of the new AREDS 2 Study.

The post Baby boomers and age-related eye disease appeared first on NJ Top Doctors Blog.

Following a diagnosis of chronic hepatitis C, a patient should ask their physician whether the liver is already damaged and whether they should begin treatment. The long-term consequences of not treating chronic hepatitis C may increase over time. The longer a patient waits to get treated for chronic hepatitis C, the more likely they are to experience severe liver damage that may make it more difficult to treat the infection.

“Guidelines issued by the Centers for Disease Control and Prevention advocate testing baby boomers born between 1945 and 1965 for chronic hepatitis C today,” says Dr. Eirum Chaudri, executive director of medical affairs at Merck. “As liver damage progresses, the likelihood of responding to treatment decreases; so testing is critical to disease identification and management.”

Anyone can be infected with chronic hepatitis C, but certain populations are more at risk than others including baby boomers, veterans and Hispanic-Americans. Given that these populations are at greater risk for the disease, it is important that they consider getting tested for hepatitis C. Testing for hepatitis C can be done with a blood test.

Patients with chronic hepatitis C should feel comfortable discussing their condition with their physician, including their treatment options. Healthcare providers are the best source of information about your medical condition.

Merck and the American Liver Foundation are teaming up to urge Americans to take action and learn more about chronic hepatitis C today. Visit www liverfoundation.org to learn more.

The post For chronic hepatitis C patients and their doctors, treatment discussions shouldn’t wait appeared first on NJ Top Doctors Blog.

1. Hepatitis B is serious

In the United States, chronic hepatitis B infection results in thousands of deaths per year. If left untreated, up to 25 percent of people with hepatitis B develop serious liver problems such as cirrhosis and even liver cancer. Liver cancer caused by the hepatitis B virus is a leading cause of cancer deaths among Asian Americans.

2. Two out of three Asian Americans with hepatitis B don’t know they are infected

People can live with hepatitis B without having any symptoms or feeling sick. Often, people don’t know they have hepatitis B until they have been tested.

“A staggering two out of three Asian Americans living with chronic hepatitis B do not know they are infected,” says Block. “Getting a simple blood test is the only way to know if you have been infected with the virus.”

3. Treatments can be lifesaving

Testing can help some people find out if they have hepatitis B in time to benefit from medical care and treatments that can save their lives. For many, treatments can help prevent serious liver damage. -

“Because of the high rate of infection among Asian Americans, testing among this population is critical to identify people living with chronic hepatitis B and help them access lifesaving medical care,” says Jeffrey Caballero, executive director of the Association of Asian Pacific Community Health Organizations (AAPCHO) and co-chair of Hep B United.

4. The vaccine can protect people who have not been infected with hepatitis B

The hepatitis B vaccine is effective and can prevent many people from getting hepatitis B. People who get tested and do not have hepatitis B can get the hepatitis B vaccine. This protects them from getting the virus. -

However, the vaccine cannot help people who already have hepatitis B. Many people with chronic hepatitis B were infected as infants or young children, before the hepatitis B vaccine was widely available. Hepatitis B spreads easily through blood or other body fluids, from someone who has hepatitis B, such as from an infected mother to her baby at birth. Today, the CDC recommends the hepatitis B vaccine for all babies born in the United States, as well as anyone else at risk for hepatitis B.

5. People who have hepatitis B can help protect their family- -

People who get tested and find out they have hepatitis B can encourage hepatitis B testing for family members and anyone living with them. Vaccinating family members who do not have hepatitis B can prevent further spread of the virus.

“Testing can also help identify other people, such as family members or sexual partners, who may be at risk for getting the disease,” says Caballero. “Remember, loving your family starts with caring for yourself, so talk to your doctor about getting tested for hepatitis B.”

The post Five reasons Asian Americans should get tested for hepatitis B appeared first on NJ Top Doctors Blog.

Any way you figure it, the math doesn’t add up to a promising picture. In 2012, there were more than 115,000 people in the U.S. awaiting an organ transplant – enough to overflow the country’s largest football stadium. Each year, more than 28,000 Americans receive a donated organ, but sadly, more than 6,500 people die each year waiting for an organ.

While many are on the waiting list for years, their number increases at the rate of more than 50,000 people a year, nearly one new person every 10 minutes. Day after day the list and the problem grow. It is, however, a problem with a solution – one that depends a lot on education and selflessness.

Professional snowboarder Chris Klug knows first-hand what the waiting game is like. After being diagnosed with PSC (Primary Sclerosing Cholangitis), a rare degenerative bile duct condition, Klug learned that he needed a liver transplant. He spent several years on the waiting list, eagerly anticipating the call that a donor organ had become available.

After a successful surgery and aggressive rehabilitation regimen, Klug won the bronze medal in snowboarding in front of the home crowd in Salt Lake City – just a year and a half after his transplant.

-”I’m so blessed to be here today,” Klug says. “I will forever be grateful for my second chance. Every day I thank God and I thank my donor and his family for the decision to donate.”

A new survey released by Astellas Pharma US, Inc. shows that while 60 percent of people are familiar with their state’s organ donor registry and 57 percent would be willing to donate their organs after they pass away, only 43 percent are actually registered as organ donors and 48 percent don’t know how to register.

“We are very encouraged by the number of Americans who view organ donation positively and are willing to donate,” says David Fleming, president and CEO of Donate Life America. “However, knowing the large number of people awaiting a transplant, we are committed to continuing to educate all Americans on the importance of registering in their state, and ensuring they know.”

Registering to become a donor is a simple process that can be completed online or through many local departments of motor vehicles. Transplantation gives hope to thousands of people with organ failure and provides many others with active and renewed lives. Register today to become an organ donor at donatelife.net/register-now.

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The concept of fetal programming (also called prenatal programming) theorizes that during fetal development, poor intake of one or more essential nutrients during critical periods in an organ’s growth can potentially alter or program the structure, size or function of that organ for the rest of the child’s life. The developing baby will attempt to compensate for deficiencies in the womb, but that compensation can carry a price later in life.

Eighty-eight percent of mothers and women who are currently pregnant agree that a diet including nutritious foods, beverages and vitamins will have a positive long term effect on their child’s health, according to a recent survey conducted by NMI Research and DSM Nutritional Products. However, despite this awareness, 99 out of 100 Americans don’t meet even the minimum standards of a balanced diet.

“Many pregnant women think they are doing OK diet-wise, but in reality they are likely not getting the essential vitamins and nutrients that they and their babies need through diet alone. For instance, the average American eats four servings or less of fruits and vegetables daily, which means they may be lacking essential nutrients like vitamins A, C, E and K,” says Elizabeth Somer, registered dietitian and author of “Nutrition for a Healthy Pregnancy.”

Today, women who are pregnant have the option to supplement their diets with prenatal vitamins, minerals and other essential nutrients. Somer provides nutrition tips for mothers to help support their child’s future health.

Tip No. 1: A mother’s diet rich in vitamin B12 has been found to correlate to a lower risk for insulin resistance in her child later in life, according to the Prune Maternal Nutrition Study. Vitamin B12 is essential for the formation of blood cells, nerve sheaths and various proteins, and is also necessary for growth. Sources of B12 include meat, eggs, fish and milk products.

Tip No. 2: Vitamin C status has been shown to lower oxidative damage to fetal tissues and lower the risk for heart problems later in life. Stock your fruit and vegetable basket with popular food sources of vitamin C, including citrus fruits, strawberries, kiwi, broccoli, spinach and tomatoes.

Tip No. 3: There is emerging evidence that vitamin D deficiency may be a risk factor for many chronic diseases, including rickets, multiple sclerosis, heart disease, type 1 diabetes and cancer, according to a study published in the Journal of Midwifery & Women’s Health. You can find a multiple vitamin and mineral supplement that includes vitamin D and is formulated for the needs of women who are pregnant.

Tip No. 4: DHA omega-3 is an important building block of a baby’s brain. In fact, 97 percent of the omega-3s found in the brain is DHA. Primary sources of DHA include fatty fish (tuna, mackerel, salmon) and a vegetarian and sustainable source of DHA from algae can be found in foods, beverages and supplements on store shelves. Look for the life’sDHA logo on the packaging to know you’re getting a vegetarian source.

Tip No. 5: Children born of mothers with low folate status during pregnancy were 57 percent more likely to have emotional problems later in life, according to a study published in the American Journal of Clinical Nutrition. Increase your folate or folic acid intake by eating dark leafy greens or supplementing with 600 to 800 micrograms of folic acid daily.

It is important to talk with your doctor before starting any supplement program.

The post Programming your child’s health – 5 nutrition tips for baby’s future health appeared first on NJ Top Doctors Blog.

Scotch Plains, NJ – May 2013 –

NJ Top Docs Include:

Acupuncture
Ross Rosen
Center for Acupuncture and Herbal Medicine
Union County

Cardiology
Dr. Bart DeGregorio
Essex County

Dr. Abbas Shehadeh
Essex

Cosmetic/Plastic Surgery, Facial Plastic Surgery, Plastic/Cosmetic Surgery
Dr. Scott Spiro
Spiro Plastic Surgery
Essex County

Orthopedic Surgery
Femino-Ducey- Queler Orthopaedic Group
Essex County

Dr. Paul Kovatis  
Orthopedic Spine & Sports Medicine Center
Bergen County
Orthopedic Surgery – Foot & Ankle

Dr. Kenneth Kopacz, Dr. Casey Lee & Dr. Christopher Zarro
Spine Care and Rehabilitation
Essex County
Orthopedic Surgery & Spinal Disorders

Dr. Raphael Longobardi
Univeristy Orthopaedic Center
Bergen County
Orthopedic Surgery & Sports Medicine

Pediatric Cardiology

Dr. Donald Putman &Dr. Jared LaCorte
Metro Pediatric Cardiology Associates
Essex County
Pediatric Cardiology

Reproductive Medicine & Infertility
Dr. Jane Miller
North Hudson IVF
Bergen County

NJ Top Dentists Include:

General Dentistry
Dr. Edward Gaines
Lawrence Dental
Mercer County

Dr. Richard Meleo & Dr. Jane Ligums
Somerset County

Pediatric Dentistry
Dr. Irvin Sherman
Shore Children’s Dental Care
Monmouth County

These providers were chosen based a number of criteria including but not limited to:

• Years in practice
• Board certification review
• Education & Training
• Review of malpractice insurance and license
• Continuing education requirements
• Patient reviews                        

NJ Top Docs is a comprehensive information resource of Top Doctors, Dentists and Hospitals. We profile over 900 Healthcare Providers, in over 100 specialties across the state and have made it convenient for you to find them.

NJ Top Docs and NJ Top Dentists allow patients to “meet” these providers online before making their appointment.

For more information, e-mail us at info@NJTopDocs.com and/or visit www.NJTopDocs.com.

The post NJ Top Docs and NJ Top Dentists are proud to feature the following April 2013 approved providers: appeared first on NJ Top Doctors Blog.

Scotch Plains, NJ – April 2013

Dr. Gregory J. Gallina, an NJ Top Doc, is recognized as being a leading expert in the surgical and non-surgical treatment of disease of the colon, rectum, anus, and small bowel with a specialization in robotic colon surgery. With over 20 years of experience, Dr. Gallina has been awarded numerous awards, including NJ Top Doctors 2011 – NJ Monthly, the Gold Doc Award 2010- Arnold Gold Foundation, and Patient Choice Award 2008, 2009, 2010, 2011 among others.

Dr. Gallina specializes in treating diverticular disease, familial colorectal cancer syndromes, ulcerative colitis, anal cancer, rectal prolapse, and pilonidal disease along with many other disorders. He is a renowned expert in screening and surveillance for colon cancer, colonoscopies, minimally invasive intestinal surgery, colostomy sparing surgery, and Da Vinci robotic surgery for rectal cancer.

A colon and rectal surgeon has the knowledge and skill to diagnose and treat an array of diseases of the small intestine, colon, rectum, anal canal, and perianal area through medical and surgical means. These specialists also deal with other tissues and organs that may consequently be affected by intestinal diseases. As an outstanding colon and rectal surgeon, Dr. Gallina understands all of the aspects of the diagnosis and treatment of these disorders as he stays in the forefront of novel technologies in his area of expertise.

Dr. Gallina has extensive experience in the treatment of:

Rectal bleeding
Hemorrhoids
Diverticular Disease (including diverticulitis)
Familial Colorectal Cancer Syndromes
Polyps of the Colon and Rectum
Ulcerative Colitis
Anal Cancer
Rectal Prolapse
Anal Abscess/Fistula
Anal Fistula
Anal Warts
Pilonidal Disease

Dr. Gallina’s practice is conveniently located in Northern, New Jersey.  For more information please visit Dr. Gallina’s full profile at http://www.NJTopDocs.com/DrGallina

About Us

NJTopDocs.com is a comprehensive information resource of Top Doctors, Dentists and Hospitals. We are profiling over 900 Healthcare Providers and have made it convenient for you to find them.

NJTopDocs.com allows patients to “meet” these providers online before making their appointment.

For more information, e-mail us at info@NJTopDocs.com and/or visit www.NJTopDocs.com.

You can also follow us on Facebook – Twitter – YouTube

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