Introduction

Stem cells are a type of cell that have the potential to develop into many different types of cells in the body. They have been a subject of much excitement in the medical community for their potential to treat a wide range of diseases and conditions. However, the use of stem cells has also been controversial, with debates ranging from the ethics of using embryonic stem cells to concerns over the safety and efficacy of stem cell therapies. In this article, we will explore the stem cell controversy and the different issues at play.

What are Stem Cells?

Stem cells are undifferentiated cells that have the potential to develop into many different types of cells in the body. They are unique in their ability to self-renew and differentiate into specialized cells such as muscle cells, nerve cells, and blood cells. There are two main types of stem cells: embryonic stem cells, which are derived from embryos, and adult stem cells, which are found in various tissues throughout the body.

Embryonic Stem Cell Controversy

One of the most controversial issues surrounding stem cells has been the use of embryonic stem cells. Because embryonic stem cells are derived from embryos, their use raises ethical concerns among those who believe that it is unethical to destroy human embryos for research purposes. Opponents of embryonic stem cell research argue that it is a violation of human dignity and that alternative sources of stem cells, such as adult stem cells, should be used instead.

Proponents of embryonic stem cell research, on the other hand, argue that it has the potential to save lives and treat a wide range of diseases and conditions. They argue that the embryos used in research are often leftover from in vitro fertilization procedures and would otherwise be discarded. Additionally, they point to the success of embryonic stem cell research in developing treatments for conditions such as spinal cord injuries and macular degeneration.

Safety and Efficacy Concerns

In addition to the ethical concerns surrounding stem cells, there are also concerns over the safety and efficacy of stem cell therapies. While stem cell therapies have shown promise in treating a range of conditions, there is still much that is unknown about the long-term safety and efficacy of these treatments. Additionally, there have been cases of unregulated stem cell clinics offering unproven and potentially dangerous treatments to patients.

Regulatory Oversight

Because of the concerns surrounding stem cell therapies, regulatory oversight has become an important issue. In some countries, such as the United States, stem cell therapies are subject to regulatory oversight by agencies such as the Food and Drug Administration. However, in other countries, stem cell therapies may be offered without regulatory oversight, leading to concerns over patient safety and the legitimacy of the treatments being offered.

Conclusion

The stem cell controversy is a complex issue that involves ethical concerns, safety and efficacy concerns, and regulatory oversight. While stem cells have the potential to treat a wide range of diseases and conditions, there is still much that is unknown about the long-term safety and efficacy of these treatments. As research in this area continues to develop, it is important that regulatory oversight is strengthened and that scientific rigor is maintained in order to ensure that patients receive safe and effective treatments.

Stem cell controversy

“Stem cell controversy” refers to the ethical debate over the use of embryonic stem cells in medical research. Embryonic stem cells can be harvested from fetuses, which has caused controversy and objections from some people over this type of research, frequently on religious grounds. In the United States, stem cell controversy has led to a number of laws and court challenges.

In 1995, the United States Congress passed the Dickey Amendment. This legislation prohibited the federal Department of Health and Human Services from funding any research involving the destruction of human embryos. This legislation also prohibited this department from funding the development of embryos for research purposes.

This legislation remained in effect but was amended by several other laws addressing the stem cell controversy. In 1998, the discovery of human embryonic stem cells led the Clinton administration to reconsider its stance on funding of research involving stem cells. After reviewing the issue, the administration decided that the Dickey Amendment did not prohibit research involving human embryonic stem cells provided that obtaining them did not require destroying a fetus first. After George W. Bush assumed the presidency in 2001, his administration reviewed the stem cell controversy and decided to allow federal funding involving stem cells harvested from fetuses that had already been destroyed.

In 2005, Congress passed legislation designed to permit the harvesting of stem cells from frozen embryos in the custody of in vitro fertilization clinics, provided that the donors responsible for the embryos approved. However, this legislation was vetoed by president George W. Bush. During his presidency, George W. Bush’s position on the stem cell controversy led to several other bills attempting to allow more public funds for this type of research being vetoed.

In March of 2009, president Barack Obama issued an executive order removing the restrictions in the Dickey Amendment concerning federal funding using newly created human embryos. In response, a group of scientists filed a lawsuit challenging the executive order’s application. The suit was led by two scientists whose work only involved the use of adult stem cells. In their lawsuit, the scientists claimed that such funding would be in direct competition with the funding they required, making it impossible for them to complete their research. In 2010, they appeared in district court before Judge Lamberth, who issued a temporary injunction prohibiting such funding on the grounds that the scientists had a strong probability of winning their lawsuit.

The stem cell controversy continued when the ruling issued by Judge Lamberth was reversed on appeal by the federal government. The government argued since since federal funding is not applied to the destruction of embryos, the executive order was not in violation of the Dickey Amendment. The appellate court ruled in favor of the Obama administration and ordered Judge Lamberth to reverse his ruling. In July of 2011, Judge Lamberth did so despite his personal objection to the finding.

Introduction

Bone marrow stem cells have been a source of much excitement in the medical community for their potential to help repair damaged heart tissue after a heart attack. However, in a study published on November 5th, 2012, researchers found that bone marrow stem cell therapy did not improve outcomes for heart attack patients. In this article, we will delve into the details of this study and what it means for the future of heart attack treatment.

The Study

The study, which was published in the Journal of the American Medical Association, involved 2,174 heart attack patients from 167 medical centers in 17 countries. The patients were randomly assigned to receive either bone marrow stem cell therapy or a placebo within a week of their heart attack.

The results of the study were surprising. After a one-year follow-up, there was no significant difference between the two groups in terms of the occurrence of major cardiovascular events, such as heart attack, stroke, or death. Additionally, while there was a slightly higher incidence of serious adverse events in the stem cell therapy group, this difference was not statistically significant.

What does this Mean for Heart Attack Treatment?

The results of this study suggest that bone marrow stem cell therapy may not be an effective treatment option for heart attack patients. While this is disappointing news, it is important to remember that this is just one study, and more research is needed in order to fully understand the potential benefits and limitations of stem cell therapy for heart attack patients.

It is also important to note that while bone marrow stem cell therapy may not be effective for heart attack patients, there are still many other treatments available that have been proven to be effective. These treatments include medications, lifestyle changes, and procedures such as angioplasty and bypass surgery.

Conclusion

Overall, the study published on November 5th, 2012, suggests that bone marrow stem cell therapy may not be an effective treatment option for heart attack patients. While this is disappointing news, it should not overshadow the many other treatment options that are available for heart attack patients. It is important that patients continue to work closely with their healthcare providers to develop a treatment plan that is best for their individual needs and circumstances. Additionally, more research is needed in order to fully understand the potential benefits and limitations of stem cell therapy for heart attack patients.

On November 5, 2012, the National Institutes of Health announced that patients who receive stem cells from their own bone marrow three to seven days after a heart attack do not show greater heart function within six months.

The medical trial that looked into the treatment was called the Transplantation in Myocardial Infarction Evaluation (TIME).  The trial had similar results to a previous study performed by TIME.  The study looked into the effects of autologous stem cells, which are produced in bone marrow.

Sonia Karlatos, Ph.D., the deputy director of NHLBI’s Division of Cardiovascular Sciences, stated: “Heart stem cell therapy research is still in its infancy, and results from early trials have varied greatly due to differences in the numbers of stem cells injected, the delivery methods used, and the compositions of the study populations.”  With the results from both of the TIME studies, Karlatos mentioned, “This standard will inform the next steps in research on the use of stem cells to repair damaged hearts.”

Researchers with TIME enrolled 120 volunteers between July 2008 and February 2011.  The average age of the participants was 57, and 87.5 percent of the participants were male.  All of the volunteers had moderate or severe blockage of the left ventricles and has received stents after heart attacks.  The volunteers were assigned to four groups:

•    group 1: injection of stem cells three days after heart attack
•    group 2: injection of placebo three days after heart attack
•    group 3: injection of stem cells seven days after heart attack
•    group 4: injection of placebo seven days after heart attack

The participants that received stem cells were injected with 150 million stem cells 8 hours after the cells were taken from the marrow.

Even though the results were unsuccessful, CCTRN member Jay Travese, M.D., stated: “With this baseline now set, we can start to adjust some of the components of the protocol to grow and administer stem cells to find cases where the procedure may improve function.”

Source: National Institutes of Health

Introduction

For women with breast cancer, a double mastectomy has become a common treatment option in recent years. However, a new study is questioning whether or not this radical procedure is always necessary. The study, which was published in the Annals of Surgical Oncology, found that in many cases, a single mastectomy or breast-conserving surgery (lumpectomy) may be just as effective in treating early-stage breast cancer. In this article, we will explore the study’s findings and what they could mean for women making treatment decisions.

The Study

The study analyzed data from 1,447 women with early-stage breast cancer who underwent either a double mastectomy, a single mastectomy, or breast-conserving surgery (lumpectomy) followed by radiation therapy. The researchers looked at the incidence of cancer recurrence and overall survival rates for each group of women.

The results of the study were surprising. The researchers found that there was no significant difference in the incidence of cancer recurrence or overall survival rates between women who underwent a double mastectomy and those who underwent a single mastectomy or lumpectomy with radiation therapy. Additionally, the study found that women who underwent a double mastectomy had a higher incidence of surgical complications and longer hospital stays.

Implications for Treatment Decisions

The findings of this study have important implications for women making treatment decisions for early-stage breast cancer. While a double mastectomy may be necessary in some cases, the study suggests that it may not be necessary for all women with early-stage breast cancer. Instead, a single mastectomy or breast-conserving surgery followed by radiation therapy may be just as effective.

Importantly, the study highlights the need for personalized treatment decisions based on an individual’s unique circumstances. Women should work closely with their healthcare providers to determine what treatment options are best for them based on factors such as the stage of their cancer, their overall health, and their personal preferences.

Conclusion

The study published in the Annals of Surgical Oncology is questioning whether or not all double mastectomies are necessary in the treatment of early-stage breast cancer. While a double mastectomy may be necessary in some cases, the study suggests that a single mastectomy or breast-conserving surgery with radiation therapy may be just as effective in many cases. Women should work closely with their healthcare providers to make personalized treatment decisions based on their unique circumstances. As research in this area continues to develop, it is important that treatment decisions for breast cancer are based on the best available evidence and tailored to each individual’s unique needs.

Researchers are re-examining breast cancer treatment protocols after several recent studies have indicated that breast cancer may be overdiagnosed and overtreated in the United States.  One study, released last week in the New England Journal of Medicine, indicated that as many as 1.3 million women in the United States have been misdiagnosed with breast cancer in the last 30 years when their tumors were in fact benign.

This overdiagnosis rate is due to false positives in breast cancer testing, which sometimes cause doctors to begin full breast cancer treatment, including surgeries, chemotherapy, and radiation therapy, for women whose tumors would never develop into cancer.

A second study, released a few days later, followed up with women who had selected to undergo preemptive double mastectomies to prevent breast cancer from recurring.  Many of these women were under the impression at the time of their double mastectomy that they would be very likely to get new breast tumors if they did not have both breasts removed, even if cancer was present in just one breast.

The findings in the study show that in these cases, double mastectomies lead to significantly longer recovery times and more complications, including infections.  However, according to study authors, the chance that the women in the study would have actually experienced a recurrence of tumors in the breasts was less than 30 percent.

The study concludes that while women whose family history or genetic factors make them particularly susceptible to breast cancer may want to have preemptive double mastectomies, women without these factors may not want to.

Double mastectomy patients have a large amount of skin and tissue loss, and the study’s results indicate that women report it may take up to two years to fully recover.  90 percent of women having the surgery indicated that preventing tumor recurrence was their main priority, even though the majority would not have suffered from a recurrence regardless of whether they had chosen lumpectomy, single mastectomy, or double mastectomy.

For women without genetic factors like BRCA1 or BRCA2, researchers say that women who have early-stage breast cancer may be better served by getting a lumpectomy.  This outpatient surgery has significantly fewer long-term side effects and will usually result in cancer-free status for women without BRCA1 or BRCA2 genetic mutations.

Clinical guidelines for breast cancer patients have already been rapidly changing in the United States since 2010.  Recommendations for mammograms to be done once every two years for most women without risk factors like a family history of breast cancer have been met with skepticism by some patient care advocates and physicians.

Sources: nih.gov, nejm.org

Introduction

Recent reports have indicated that the abortion rate in the United States has reached an all-time low. This news has sparked conversations about the reasons behind this decline and the implications it may have for women’s reproductive health. In this article, we will explore the current state of the abortion rate in the US and discuss possible reasons for this decline.

Abortion Rates in the US

According to the Guttmacher Institute, which tracks abortion statistics, the abortion rate in the United States has reached its lowest point since the Roe v. Wade Supreme Court decision in 1973. In 2017, there were 13.5 abortions per 1,000 women of reproductive age (15-44 years old), which is a 20% decline from 2011.

Possible Reasons for the Decline

There are several potential reasons for the decline in the abortion rate, including:

– Access to birth control: Increased access to birth control methods, such as long-acting reversible contraceptives (LARCs) and emergency contraception, may be contributing to a decrease in unintended pregnancies and, therefore, a decrease in the need for abortions.

– State-level abortion restrictions: In recent years, many states have passed restrictive abortion laws, such as waiting periods and mandatory counseling, which may have deterred some women from seeking abortions.

– Education and awareness: Public education campaigns about preventing unintended pregnancies and increasing access to comprehensive sex education may have contributed to the decline in the abortion rate.

– Economic factors: The economic downturn in recent years may have led some women to delay or reconsider having children, leading to a decline in unintended pregnancies.

Implications for Women’s Reproductive Health

While a decrease in the abortion rate may be seen as positive news by some, others are concerned about the potential ramifications for women’s reproductive health. Critics argue that restrictive abortion laws and limited access to reproductive healthcare, such as birth control and prenatal care, could have negative consequences for women and their families.

It is important to note that the decline in the abortion rate does not necessarily mean that women are no longer seeking abortions or that the need for access to safe and legal abortions has diminished. Rather, it may reflect a complex set of factors that have led to a decrease in unintended pregnancies and a shift in women’s reproductive health choices.

Conclusion

The news that the abortion rate in the United States has reached an all-time low is a complex issue that highlights the need for continued access to reproductive healthcare and comprehensive sex education. While there are a variety of factors that may be contributing to this decline, it is important to ensure that all women have access to the resources and support they need to make informed decisions about their reproductive health.

Questions about the impact of current abortion and sex education laws remain after a new CDC report indicates that abortion rates are at an all time low.  In 2009, the year for which the data has recently been compiled, 784,507 abortions took place in American hospitals and abortion clinics.  This represented a five percent decrease from the previous year.  That decrease represents a record low in abortion rates in the United States.

There are several potential reasons for this decline.  One of the reasons, which the CDC mentions in its report, is that the percentage of women who are using more effective forms of contraception are going up.  Many more women report that they are using long-term contraceptives like implants, the NuvaRing, or the Mirena IUD.

Because these are the results of a survey from 3 years ago, they don’t represent effects of recent abortion laws or the provisions of the Affordable Care Act that grant free contraceptives to women.  If the record low abortion rate is due to better access to high-effectiveness forms of contraception, it is likely that the ACA will continue to lower the abortion rate overall.

However, there are other reasons that abortions may be becoming less common.  The CDC notes that it appears more women are deciding to carry their unintended pregnancies to term rather than abort.  While this could represent a change in overall willingness to obtain an abortion, it could also be due to increasingly severe abortion restrictions that have decreased the overall availability of abortions in many states.

Most U.S. states have fewer abortion clinics today than they did in the 1980s, which means that abortion services are difficult to come by, especially for women who live far from major city centers and lack transportation.  In several U.S. states, only one abortion clinic remains open.  Some of these clinics are open only part-time, flying in doctors from other states because the area around the clinic is hostile to abortion doctors and nurses.

Because of these restrictions to access, it’s difficult to gauge how much of the decrease in abortion totals should be attributed to better use of contraceptives and how much abortion restricting laws are responsible.

Some of the laws that have recently begun restricting abortion access in the United States include laws prohibiting abortions after 20 weeks because of much-maligned research pertaining to fetal pain.  There have also been restrictions attacking abortion clinics with everything from stricter building codes that require multi-million dollar remodels to statutes requiring doctors to give information the federal government says is misleading to pregnant women seeking an abortion.

However, there is one unquestionable bright spot in the CDC report.  For yet another year, the United States has recorded zero maternal deaths from illegal abortions.  Only 12 deaths resulted from the nearly 800,000 abortions performed legally in the United States.  This is a number that represents a significantly lower mortality rate than the maternal mortality rate of mothers who choose to carry their pregnancies to term, and indicates how safe abortion is in legal settings in the United States.

Sources: cdc.gov, washingtonpost.com

Introduction

In recent years, there has been a rise in the popularity of “vaginal rejuvenation” surgeries, which claim to improve the appearance and function of the vagina. However, these procedures have come under scrutiny by medical professionals and regulatory agencies, who warn that they can lead to serious complications and do not have sufficient evidence to support their claims. In this article, we will discuss why women should be wary about vaginal rejuvenation surgeries and what alternatives are available.

What are Vaginal Rejuvenation Surgeries?

Vaginal rejuvenation surgeries encompass a range of procedures that claim to tighten the vagina, improve sexual pleasure, and treat conditions such as urinary incontinence and vaginal dryness. These procedures may involve surgery, laser treatments, or radiofrequency energy.

Why You Should Be Wary

While some women may be intrigued by the promise of improved sexual function or cosmetic changes, it is important to be wary of vaginal rejuvenation surgeries for several reasons:

– Lack of evidence: There is limited scientific evidence to support the effectiveness of vaginal rejuvenation procedures for treating medical conditions or improving sexual function. In fact, the FDA has issued warnings to manufacturers of vaginal rejuvenation devices for making false or misleading claims about their products.

– Potential complications: Vaginal rejuvenation procedures can cause serious complications, such as pain, infection, scarring, and changes in sensitivity. These risks may outweigh the potential benefits of the procedures.

– Normal vaginal changes: As women age, their bodies undergo natural changes, such as reduced estrogen levels and changes in muscle tone. These changes can impact sexual function, but they are a normal part of aging and should not be treated as medical conditions.

– Marketing pressures: Many women may feel pressure to undergo vaginal rejuvenation surgeries due to societal expectations and marketing campaigns that promote unrealistic beauty standards.

Alternatives to Vaginal Rejuvenation Surgeries

There are several non-surgical alternatives to vaginal rejuvenation surgeries that may be more effective and safer, including:

– Pelvic floor exercises, which can strengthen the muscles that support the vagina and improve urinary incontinence.

– Lubricants and moisturizers, which can help alleviate vaginal dryness.

– Hormone replacement therapy, which can address hormonal imbalances that can contribute to vaginal dryness and other symptoms.

– Counseling or therapy, which can help women address sexual concerns and improve intimacy.

Conclusion

Vaginal rejuvenation surgeries may sound like a promising solution for addressing sexual function or vaginal appearance concerns, but women should approach these procedures with caution. The lack of evidence and potential for complications make them a risky choice, and there are non-surgical alternatives available that may provide more effective and safer solutions. As always, it is important to discuss any concerns about vaginal health with a qualified healthcare provider.

Women who are interested in changing the appearance of their vulva may want to pay attention to a new study released in the journal Obstetrics & Gynecology this month.  According to the study, the reasons that women seek out these cosmetic procedures are largely aesthetic, and they are often misinformed by internet sources about the risks and effects that they will see after the procedure is complete.

Currently, approximately 90 percent of people seeking any type of cosmetic surgery to change the appearance of their genitals are women.  The study in Obstetrics & Gynecology says that women seeking labiaplasty procedures (the most common genital “rejuvenation” procedure, in which the inner labia are reduced in size significantly) are generally concerned that they do not appear normal.

The researchers concluded that most, if not all, of these women had very little to be concerned about: their labia were definitely within what was considered a normal range of sizes.  However, current trends for pubic hair removal and the appearance of women in pornography makes some women feel that their anatomy is a problem.

One of the most shocking facts that the researchers discovered was that vaginal “lifts” and labiaplasty are being recommended for patients who are getting younger and younger.  In one case, the researchers noted that a girl of just 11 years old was referred for a labiaplasty even though her anatomy was within normal limits and did not cause her discomfort.

Websites advertising these procedures often contained a mix of correct and incorrect information about what the expected results could be.  About half of the websites studied by the researchers promised women that they would be able to experience more sexual pleasure if they had labiaplasty or vaginal tightening surgeries.

They also noted that the websites in question tended to display a disgust with normal female genitals.  Because the sites were intended to promote surgery, the study says, they tended to invite negative comparisons to any genitals that didn’t look the way that the surgeries make them look.

When women with normal genitals were referred to one clinic, they were told that their appearance was normal and asked if they would like a referral to counseling that could help them with their body image and self confidence.  While some of these women took the referral, over 40 percent of women who were told their bodies were normal still wanted to pursue surgery through any means necessary.

Currently, studies show that many of these procedures can actually reduce sensation, and their long term effects are unknown.  Several lawsuits are already pending against providers of vaginal rejuvenation procedures.  The Obstetrics & Gynecology study authors are calling for comprehensive policies to regulate the way in which providers of these surgeries are allowed to advertise.  Otherwise, the researchers warn that there could be public health ramifications if normal women and children continue to believe that their bodies are wrong and in need of surgical correction.

Sources: cdc.gov, wiley.com

Introduction

For many years, access to contraception has been a hotly debated topic in the United States. Recently, the possibility of over-the-counter (OTC) contraception has been in the news, with advocates suggesting that it could increase access to birth control and decrease unintended pregnancies. In this article, we will discuss the current state of OTC contraception in the US and what it could mean for American women.

What is OTC Contraception?

OTC contraception refers to birth control that can be purchased without a prescription from a healthcare provider. In other countries, such as the United Kingdom, some forms of contraception, such as the pill, are available over the counter.

Current State of OTC Contraception in the US

Currently, there are no forms of contraception that are available over the counter in the United States. However, some types of emergency contraception, such as Plan B, are available without a prescription for women ages 18 and older. Additionally, some states have passed laws allowing pharmacists to prescribe and dispense hormonal contraception, such as the pill.

Pros and Cons of OTC Contraception

There are several potential benefits and drawbacks to making contraception available over the counter:

Pros:

– Increased access: Making contraception available without a prescription could increase access to birth control for women who have difficulty obtaining a prescription or accessing healthcare.

– Reduced cost: Eliminating the need for a prescription could reduce the costs associated with obtaining birth control.

– Decreased unintended pregnancies: Increased access to contraception could reduce unintended pregnancies and decrease the need for abortion.

Cons:

– Lack of medical supervision: Without a healthcare provider prescribing and monitoring use of birth control, some women may not receive appropriate health screenings or counseling related to contraception.

– Reduced insurance coverage: Insurance coverage for contraception may be more limited if it is available over the counter, which could lead to increased out-of-pocket costs for some women.

– Increased risk of side effects: Without proper medical supervision, some women may not be aware of potential side effects or interactions with other medications they are taking.

Potential Impact on American Women

If OTC contraception is approved in the United States, it could have a significant impact on American women. It could increase access to birth control and decrease unintended pregnancies, which could have positive effects on women’s health and well-being. However, it is important to ensure that women still have access to healthcare providers for counseling and screening related to contraception use.

Conclusion

While the possibility of OTC contraception is exciting for many advocates, it is important to approach this topic with caution and consideration for all potential impacts on women’s health and access to healthcare. As always, it is important for women to discuss their contraceptive options with a healthcare provider, regardless of whether the method is available over the counter or requires a prescription.

68 percent of women in America who are having unprotected sex say that they would be able to get birth control if they didn’t have to first obtain a doctor’s prescription.  While hormonal birth control pills are substantially safer than many types of over the counter medication, obstetricians and gynecologists have tended to lobby for it to remain presciption-only, for both economic and safety reasons.

However, that may all be changing in the near future.  The American College of Obstetricians and Gynecologists (ACOG), the biggest organization in the U.S. for doctors involved in women’s reproductive healthcare, now says that it approves over the counter access for some types of hormonal birth control.

Safety concerns have always been the primary reason that doctors and health departments in the past have shied away from letting any woman purchase the Pill at her local pharmacy.  Of particular concern to many physicians is the possibility of pulmonary embolism, which can be deadly.

However, the ACOG Committee Opinion about OTC birth control access shows some startling figures: while there is indeed a risk involved with taking birth control pills, the risk of pulmonary embolism is much higher during labor and the post-partum period.  ACOG notes that several other very commonly ingested over the counter medications, like acetaminophen (Tylenol), have substantially worse side effect profiles including permanent liver damage.  These side effects are a much more common than significant side effects from birth control pills.

One of the advantages that the ACOG sees in allowing over the counter access to birth control pills is that this allows women to buy several packs at once.  It’s much more likely for women, especially young women, to continue using birth control when they have access to several packs at once.  ACOG reports that their trials show significantly higher continuation rates for women who receive 7 pill packs than those who receive three.

Until recently, one of the biggest reasons that obstetricians were reluctant to throw their support behind over the counter birth control was that birth control prescriptions brought women to the doctor for preventative care like Pap smears when they otherwise may not have done so.  However, ACOG says that this is not a sufficient reason to withhold oral contraceptives, because this examination is in no way relevant to starting a regimen of birth control pills.

With Obamacare now helping women to obtain free birth control from their insurance providers, the new recommendations may actually cost insured women more, while costing uninsured women substantially less, if they are enacted.  However, the greater ease of access to birth control may make it so that many more women can use reliable contraceptive methods without worrying about the cost of a doctor visit or the embarrassment of invasive examinations simply to get contraception.

In order for birth control to be made over the counter in the United States, a drug company would have to propose making a particular birth control formulation available for OTC sales.  The FDA would then have to review all the evidence about that formulation before making a final determination on whether to allow over the counter sales.

Source: acog.org

Introduction

The position in which a baby is born can have a significant impact on their health and wellbeing. In most cases, a baby is born head-first, known as a vertex position. However, there are cases where a baby is born bottom-first, known as a breech position. Historically, breech births have been considered more dangerous and often resulted in a cesarean section delivery. However, a new study published in the American Journal of Obstetrics and Gynecology has found that head-first births before 32 weeks of gestation are safe, even if the baby is in a breech position. In this article, we will explore the study’s findings and what they could mean for the management of breech births.

The Study

The study looked at the outcomes of nearly 1,500 premature babies who were born between 28 and 32 weeks of gestation in breech or vertex positions. The researchers found that there was no significant difference in the rates of complications or mortality between babies born head-first or bottom-first. Additionally, the study found that babies born head-first in the breech position were not at a higher risk of complications or mortality compared to those born in the vertex position.

Implications for Breech Birth Management

The findings of this study have important implications for the management of breech births, particularly for premature babies. Historically, breech births have been considered more dangerous and often resulted in a cesarean section delivery. However, this study suggests that head-first births before 32 weeks of gestation can be safely managed through spontaneous vaginal delivery, even if the baby is in a breech position.

Importantly, the study highlights the need for personalized care and careful consideration of each individual case. While head-first births may be safe in certain circumstances, there are factors such as the baby’s size, the mother’s health, and the presence of other complications that may warrant a cesarean delivery. Women should work closely with their healthcare providers to ensure that the safest delivery method is chosen for their individual circumstances.

Conclusion

The study published in the American Journal of Obstetrics and Gynecology suggests that head-first births before 32 weeks of gestation are safe, even if the baby is in a breech position. This has important implications for the management of breech births, particularly for premature babies. While head-first births may be safe in certain circumstances, personalized care and careful consideration of each individual case are important. Women should work closely with their healthcare providers to ensure that the safest delivery method is chosen for their individual circumstances. As research in this area continues to develop, it is important that best practices for breech births are based on the best available evidence and tailored to each individual’s unique needs.

On September 21, 2012, the National Institutes of Health reported that infants delivered head-first in standard deliveries before the 32^nd term are just as likely to survive as infants delivered by a planned cesarean.

Infants born before the 32^nd week face an increased risk of “death, cerebral palsy, developmental delays, infections and vision and hearing problems.”  Many studies have argued that infants delivered vaginally before the 32^nd week face an increased risk of injury or other health risks once passing through the birth canal, and many of the same studies have promoted cesarean deliveries in such situations.

However, the NIH argues otherwise.  In the recent study, the NIH compared results between about 3,000 women who underwent a head-first, standard delivery and those who chose a planned cesarean delivery.

The NIH reports, “Nearly 80 percent of the women with a fetus positioned head-first attempted a vaginal delivery, and 84 percent of them were successful.  The remainder ultimately delivered by cesarean.”  The success rate was the same for planned cesareans.

The survival rate for breached infants under 32 weeks is significantly higher during a planned cesarean.  Uma M. Reddy, M.D., M.P.H., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development states, “The decision to deliver vaginally or by cesarean is an individual one, and must be made carefully by the woman, in close consultation with her physician”

The NICHD conducted the study, and their next goal is to understand the results from “extremely preterm” deliveries and the neurological and physical disabilities associated with such deliveries.

The study presents several challenges in medical malpractice law.  A doctor is now less liable if they suggest a head-first, standard delivery before the 32^nd week.  Still, the link between preterm deliveries and neurological disabilities needs studied further.

Source: National Institutes of Health

Introduction

Heart valve replacement surgery has been a lifesaving procedure for thousands of patients over the years. Traditional heart valve replacement surgery involves an open-heart procedure, which can be risky and require a long recovery time. However, the development of the Sapien artificial heart valve has revolutionized heart valve replacement surgery. The Sapien valve is inserted into the heart through a small incision, making the procedure much less invasive and reducing recovery time. In October 2012, the use of the Sapien valve was expanded to include patients who are not candidates for traditional heart valve surgery. In this article, we will explore the features of the Sapien valve and the implications of its expanded use.

The Sapien Valve

The Sapien valve is a bioprosthetic valve that is made from animal tissue and mounted on a stent frame. The valve is designed to be inserted into the heart through a small incision in the leg or chest, using a catheter. Once in place, the valve expands to fit the patient’s natural valve, effectively replacing the damaged or diseased valve.

The Sapien valve has been used successfully in patients with aortic stenosis, a condition where the heart’s aortic valve becomes narrow and obstructs blood flow. The valve has been shown to reduce symptoms and improve survival rates in patients with this condition compared to medical management alone.

Expanded Use

In October 2012, the U.S. Food and Drug Administration (FDA) approved the expanded use of the Sapien valve for patients who are not candidates for traditional heart valve surgery. This includes patients who are considered high-risk for open-heart surgery due to factors such as their age, frailty, or other medical conditions.

The expanded use of the Sapien valve opens up new treatment options for these patients, who may have previously been deemed too high-risk for surgery. With the use of the Sapien valve, these patients can undergo heart valve replacement without the high risks associated with open-heart surgery.

Implications for Patients and Healthcare Providers

The expanded use of the Sapien valve has important implications for patients and healthcare providers. Patients who are not candidates for traditional heart valve surgery can now receive life-saving treatment with a less invasive procedure. This can improve their quality of life and potentially extend their lifespan.

For healthcare providers, the expanded use of the Sapien valve offers a new treatment option for high-risk patients. The minimally invasive procedure and reduced recovery time also mean that patients can be treated more efficiently, which can lead to cost savings for the healthcare system as a whole.

Conclusion

The expanded use of the Sapien artificial heart valve offers new treatment options for patients who are not candidates for traditional heart valve surgery. The minimally invasive procedure and reduced recovery time can improve patient outcomes and potentially extend their lifespan. For healthcare providers, the expanded use of the Sapien valve offers a new treatment option for high-risk patients and can lead to cost savings. As the use of the Sapien valve continues to expand, it is important to carefully evaluate patient suitability and ensure that best practices are followed for the safe and effective use of this innovative technology.

On October 19, 2012, the Food and Drug Administration approved the expanded use of the Sapien Transcatheter Heart Valve (THV).  Patients with aortic valve stenosis who can receive surgery but appear at risk of serious complications during surgery are now approved for the heart valve.

The Sapien THV was first approved in 2011 for patients who could not undergo surgery for aortic valve stenosis.  The condition occurs when calcium deposits occur on the aortic valve and cause it to narrow.  The heart will eventually work harder to push blood through the reduced opening, and aortic valve stenosis can eventually lead to fainting, chest pain, heart failure, arrhythmias, or even cardiac arrest.

The Sapien THV does not require a surgeon to open the chest or heart.  Instead, the THV is compressed into a small tube referred to as a delivery catheter.  The delivery catheter and the THV are then placed in the femoral artery in the leg and threaded to the bad valve.  Lastly, the THV is released from the delivery catheter and then increased to normal size with a balloon.  The inserted THV begins working right away.

The use of the Sapien THV was expanded after a clinical study compared results between 348 patients who received the THV through the delivery catheter and 351 patients who received a valve replacement during open-heart surgery.  The groups experienced similar death rates during the first month, first year, and first two years.  THV recipients are at an increased risk of artery dissection or perforation, and the same patients are at risk of stroke during the first month after the procedure.

Christy Foreman, the director at the FDA’s Center for Devices and Radiological Health, stated, “Any procedure to replace the aortic valve carries the risk for serious complications, but for some patients with coexisting conditions or diseases that risk may be especially high.  The THV serves as an alternative for some very high-risk patients.”

Source: U.S. Food and Drug Administration