The Obama administration is preparing to roll back a rule that prevents discrimination against medical workers who refuse to take part in procedures, provide medication, or hand out information based on their moral or religious beliefs. As 80beats reported in December, the Bush administration pushed the rule through as one of its final policy initiatives. Seven states, including California, Illinois and Connecticut, and two family-planning groups have filed lawsuits challenging the Bush rule. They argue that it sacrifices the health of patients to the religious beliefs of medical providers [Los Angeles Times].
Pre-existing federal law protects doctors and nurses who decline to provide abortion services because of their ethical beliefs, and changing the so-called conscience rule would have no effect on that law. But an official from the Department of Health and Human Services says the Bush administration’s rule is too broad. “We’ve been concerned that the way the Bush rule is written it could make it harder for women to get the care they need. It is worded so vaguely that some have argued it could limit family planning counseling and even potentially blood transfusions and end-of-life care” [Washington Post], an unnamed department official said.
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The recent birth of octuplets in California has riveted the nation’s attention with the strange story of Nadya Suleman, who had six young children at home but went back to a fertility clinic for more. The 33-year-old Suleman says she used in vitro fertilization to have six embryos implanted, and that two of those embryos split into twins. But the incident has shone a bright light on the $1 billion fertility industry, and has many people wondering about the ethics of implanting so many embryos simultaneously. The California Medical Board says it is investigating the doctor who implanted Suleman…. The consequences could range from a reprimand to loss of medical license [CBS News].
The American Society for Reproductive Medicine adopted guidelines in 2008 encouraging the transfer of only one embryo for women under 35, and no more than two, except in extraordinary circumstances. The guidelines allow more for older women, up to a maximum of five. But unlike some other countries, the United States has no laws to enforce those guidelines [The New York Times]. Given the expense of each attempt at in vitro fertilization and the fact that not all implanted embryos develop successfully, many women prevail upon their doctors to implant multiple embryos–according to federal statistics, only 11 percent of in vitro procedures in the United States involve a solitary embryo.
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A chemical found in common household products and cosmetics has been linked to a decrease in fertility in women, according to a new study. Researchers examined more than 1,000 pregnant women and found that those exposed to higher levels of perfluorinated chemicals (PFCs) had experienced more difficulty getting pregnant. PFCs are used to make textiles and leather resistant to water, dirt or oil. They are also found in personal care products such as nail polish, dental floss or facial moisturizer. The chemicals resist breakdown and tend to persist in the environment and in the body for decades [Bloomberg]. “If this finding can be replicated, one would have to look for other chemicals to replace these,” [Washington Post] said lead researcher Jorn Olsen. Although experts caution that the correlation doesn’t prove causation, many manufacturers have already taken steps to cut back on PFCs.
Data for the study was taken from 1,240 women in the Danish Birth Cohort when they were six to 12 weeks pregnant. If they reported that it took them longer than 12 months to get pregnant or if they used drugs designed to increase their chances of conceiving, they were considered to have infertility. This is a generally accepted definition of infertility by experts in the field [ABC News]. The women were divided into four groups based on levels of two types of PFCs, perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA), found in their blood. Compared to women in the group with the lowest levels of PFOS, women with higher levels took from 70 percent to 134 percent longer to conceive. For PFOA, women with higher levels took from 60 percent to 154 percent longer to conceive. The researchers accounted for factors such as age and economic and social factors, although they admit that they lacked information on other factors that could influence fertility such as timing and frequency of intercourse and sperm quality.
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Pharmaceutical giant Wyeth is under scrutiny for its practice of paying ghostwriters to draft scientific journal articles favorable to its products and publishing them under the names of academic researchers. Some of the ghostwritten reports involve Wyeth’s hormone replacement therapy, Prempo, and deny the results of a federal study that linked the drug to an increased risk for breast cancer. The inquiries come as part of the Senate Finance Committee’s examination of “medical ghostwriting,” part of a broader probe into the influence of drug companies on the health-care industry [Wall Street Journal].
The investigation is being spearheaded by Senator Charles E. Grassley of Iowa, who last week sent a letter to Wyeth’s chairman requesting documentation of the company’s ghostwriting and publishing procedures. The letter [pdf] said Wyeth’s publications resembled “subtle advertisements rather than publications of independent research” and that “any attempt to manipulate the scientific literature, that can in turn mislead doctors to prescribe drugs that may not work and/or cause harm to their patients, is very troubling.” In response, a Wyeth spokesman accused Mr. Grassley of recycling old arguments and insisted that “The authors of the articles in question, none of whom were paid, exercised substantive editorial control over the content of the articles and had the final say, in all respects, over the content” [New York Times].
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One in five breast cancer tumors may regress without treatment, a new study suggests. Researchers screening women who had a history of regular mammograms and those who did not report that those in the first group were diagnosed with 22 percent more breast cancers, implying that such a percentage of cancers would have eventually gone away on their own. The study opens up a controversial debate on whether early and aggressive treatment of breast cancer is always the best procedure. But many experts are wary of the new findings, saying the conclusions were incorrectly drawn and fearing they will discourage women from getting mammograms. “The idea that somehow these cancers go away entirely is, I would say, an intriguing hypothesis, but one we don’t have a lot of evidence to support,” [Reuters] said Dr. Eric Winer.
Researchers in Norway followed two groups of women, each numbering more than 100,000, for six years. The first group, monitored from 1992 to 1997, did not receive mammograms until the end of the study. (Mammograms were not common in Norway until 1996.) The second group, monitored from 1996 to 2001, received mammograms every two years. For every 100,000 women who were screened regularly, 1,909 were diagnosed with invasive breast cancer over six years, compared with 1,564 women who did not have regular screening [New York Times]—a difference of 22 percent. The researchers attribute this difference to the number of undetected tumors in the first group that vanished on their own during those six years.
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Dosing menopausal women with testosterone may be the key to helping those with low libidos get back in the mood, according to a new study. Proctor & Gamble Pharmaceuticals has published the results of a new trial of their testosterone patch, called Intrinsa, and say the results are encouraging for frustrated older women seeking a “Viagra for women.” However, nagging safety concerns are likely to keep the drug off the market in the United States for some time to come (although the drug is already on sale in Europe): During the new study, four of the test subjects using the patch developed breast cancer.
The 52-week study included 814 women with sexual desire disorder, characterized by troublesome low sexual desire or function…. The women were asked to keep sexual encounter diaries, and researchers used other established measures to assess sexual response during the six-month evaluation phase of the study. They found that compared to placebo users, the women who used the 300 microgram patch reported significant improvements in sexual functioning, including desire, arousal, orgasm, and pleasure [WebMD].
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Three researchers who discovered viruses that cause serious diseases have been awarded the Nobel Prize in medicine, the Nobel Foundation announced today. The prize was awarded jointly to France’s Francoise Barre-Sinoussi and Luc Montagnier, who worked together to identify the HIV virus that causes AIDS, and also to the German scientist Harald zur Hausen who discovered the human papilloma viruses (HPV) that can cause cervical cancer.
Barre-Sinoussi, who is the eighth woman to win the medicine prize since the first Nobel Prizes were handed out in 1901, worked with Montagnier to discover the HIV virus. Shortly after reports in the early 1980s of a new immunodeficiency syndrome, researchers all over the world raced to find the cause. The two [researchers] cultured cells from lymph nodes of patients. They first detected the enzyme reverse transcriptase, which meant that a retrovirus was active. Further searching turned up retroviral particles, which could kill white blood cells and which also reacted with antibodies from infected patients [Scientific American].
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The little blue pills that have given so many men a sexual boost may be of some use to women as well. A small study looked at women whose sex lives had suffered as a side effect of taking antidepressants, and found that Viagra increased their sexual sensation and orgasms.
However, the pills didn’t boost the women’s sex drive, leading some experts to question whether the medication could help most women. “Viagra is not a desire drug. It dilates the blood vessels, allowing intercourse to occur,” said Rutgers University psychology professor Barry R. Komisaruk, an expert on sexual dysfunction. [Sexual health expert Leonard] Derogatis agreed: “The most prevalent female sexual dysfunction is not arousal but desire. Viagra doesn’t have a direct effect on that,” he said [Baltimore Sun].
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In a few years, young women may be offered a genetic test that would gauge their probability of developing breast cancer decades later. The test, which could be a simple mouth swab, could make women who are at high risk more vigilant and could lead them to detect the disease earlier, researchers say. But some doctors warn the results could cause serious psychological stress and would not identify all women at risk [Sydney Morning Herald].
Researchers know that a woman’s risk of developing breast cancer is based on both genetics and lifestyle. Currently, women with a strong family history of breast cancer are offered genetic screenings, but those tests only look for the rare genes BRCA1 and BRCA2, which have long been known to carry a high risk of the disease. The proposed tests, which researchers say are just a few years away, would also look at seven genetic variants… which have been discovered to increase a woman’s risk of breast cancer, particularly if she has certain combinations of them [The Guardian].
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