Sunday, November 2, 2008
Saturday, November 1, 2008
Pragmatism
A husband and wife were having a fine dining experience at their exclusive country club when this stunning young woman
comes over to their table, gives the husband a big kiss, says she'll see him later and walks away.
His wife glares at him and says, "Who was that?!"
"Oh," replies the husband, "she's my mistress."
"Well that's the last straw," says the wife. "I've had enough, I want a divorce. I am going to hire the most aggressive, meanest divorce lawyer I can find and make your life miserable."
"I can understand that," replies her husband, "but remember, if we get a divorce it will mean no more wintering in Key West, or the Caribbean, no more summers in Tuscany, no more Cadillac STS in the garage, and no more country club, and we'll have to sell the 26-room house and move to two smaller homes, but the decision is yours."
Just then, a mutual friend enters the restaurant with a gorgeous young woman on his arm.
"Who's that with Jim?" asks the wife.
"That's his mistress," says her husband.
She replies, "Ours is prettier."
comes over to their table, gives the husband a big kiss, says she'll see him later and walks away.
His wife glares at him and says, "Who was that?!"
"Oh," replies the husband, "she's my mistress."
"Well that's the last straw," says the wife. "I've had enough, I want a divorce. I am going to hire the most aggressive, meanest divorce lawyer I can find and make your life miserable."
"I can understand that," replies her husband, "but remember, if we get a divorce it will mean no more wintering in Key West, or the Caribbean, no more summers in Tuscany, no more Cadillac STS in the garage, and no more country club, and we'll have to sell the 26-room house and move to two smaller homes, but the decision is yours."
Just then, a mutual friend enters the restaurant with a gorgeous young woman on his arm.
"Who's that with Jim?" asks the wife.
"That's his mistress," says her husband.
She replies, "Ours is prettier."
Friday, October 31, 2008
Freezing improves DNA integrity
Gamete cryopreservation could help improve the fertility of men whose spermatozoa show a high level of prefreeze DNA fragmentation, study findings indicate.
Laura Thomson (Fertility First, Hurstville, Australia) and co-authors note potential cryoinjury of sperm from subfertile men is an issue of primary concern “considering that subfertile men form a very large proportion of the men requiring semen cryopreservation.”
The findings were observed during a study comparing different cryoprotectants used to store spermatozoa for fertility treatment. The study involved 320 men who presented for fertility investigations and provided semen samples.
Post-thaw sperm DNA integrity was unaffected by the type of cryoprotectant used during freezing, but showed a significant, negative correlation with the prefreeze level of DNA fragmentation. Among men with prefreeze sperm DNA fragmentation levels within the normal range, 89 percent showed an increase in fragmentation post-thaw. Conversely, 64 percent of those with very high levels of prefreeze fragmentation showed a decrease in fragmentation post-thaw.
The authors suggest that the result “gives rise to a possible novel method of reducing fragmentation in sperm used for assisted reproductive technology treatment cycles, in some cases without the need for invasive and expensive testicular sperm retrievals.”
Laura Thomson (Fertility First, Hurstville, Australia) and co-authors note potential cryoinjury of sperm from subfertile men is an issue of primary concern “considering that subfertile men form a very large proportion of the men requiring semen cryopreservation.”
The findings were observed during a study comparing different cryoprotectants used to store spermatozoa for fertility treatment. The study involved 320 men who presented for fertility investigations and provided semen samples.
Post-thaw sperm DNA integrity was unaffected by the type of cryoprotectant used during freezing, but showed a significant, negative correlation with the prefreeze level of DNA fragmentation. Among men with prefreeze sperm DNA fragmentation levels within the normal range, 89 percent showed an increase in fragmentation post-thaw. Conversely, 64 percent of those with very high levels of prefreeze fragmentation showed a decrease in fragmentation post-thaw.
The authors suggest that the result “gives rise to a possible novel method of reducing fragmentation in sperm used for assisted reproductive technology treatment cycles, in some cases without the need for invasive and expensive testicular sperm retrievals.”
Thursday, October 30, 2008
Cell phone risk to sperm supported
An in vitro comparison study has strengthened concerns that electromagnetic radiation from cell phones impairs male fertility.
Ashok Agarwal (Cleveland Clinic, Ohio, USA) and colleagues set out to validate the implications of recent epidemiologic studies, which reported reductions in sperm motility, morphology, and viability associated with cell phone exposure.
They studied neat semen samples from 23 normal healthy donors and nine infertility patients. They divided the samples into two aliquots and exposed one of each sample to radiation from cell phones in talk mode, leaving the second aliquot unexposed to serve as controls.
Analysis revealed significantly lower sperm motility and sperm viability in aliquots of exposed compared with unexposed sperm (49 vs 52 percent and 52 vs 59 percent, respectively).
Levels of reactive oxygen species were also significantly higher in samples of exposed compared with unexposed sperm (0.11 vs 0.06 x106 cpm/20 million sperm), Agarwal et al report.
Total antioxidant capacity and levels of DNA damage did not differ significantly between the two groups.
“We speculate that keeping the cell phone in a trouser pocket in talk mode may negatively affect spermatozoa and impair male fertility,” the researchers conclude.
Source: Fertility and Sterility 2008; Advance online publication
Ashok Agarwal (Cleveland Clinic, Ohio, USA) and colleagues set out to validate the implications of recent epidemiologic studies, which reported reductions in sperm motility, morphology, and viability associated with cell phone exposure.
They studied neat semen samples from 23 normal healthy donors and nine infertility patients. They divided the samples into two aliquots and exposed one of each sample to radiation from cell phones in talk mode, leaving the second aliquot unexposed to serve as controls.
Analysis revealed significantly lower sperm motility and sperm viability in aliquots of exposed compared with unexposed sperm (49 vs 52 percent and 52 vs 59 percent, respectively).
Levels of reactive oxygen species were also significantly higher in samples of exposed compared with unexposed sperm (0.11 vs 0.06 x106 cpm/20 million sperm), Agarwal et al report.
Total antioxidant capacity and levels of DNA damage did not differ significantly between the two groups.
“We speculate that keeping the cell phone in a trouser pocket in talk mode may negatively affect spermatozoa and impair male fertility,” the researchers conclude.
Source: Fertility and Sterility 2008; Advance online publication
Wednesday, October 29, 2008
Gender selection: From diet to chromosomes
A link between what women eat before conception and the sex of their baby has been found in research from the Universities of Exeter and Oxford in the UK.
The results of their study show a clear association between a high energy intake before conception and the birth of sons. As well as consuming more calories, women who had sons were more likely to have eaten a higher quantity and wider range of nutrients, such as potassium, calcium, and vitamins C, E, and B12 than women who had girls. There was also a strong correlation between women who ate breakfast cereals and the birth of male children.
The study's lead author, Dr Fiona Mathews from the University of Exeter, said: "Potentially, males of most species can father more offspring than females, but this can be strongly influenced by the size or social status of the male, with poor quality males failing to breed at all. Females, on the other hand, reproduce more consistently. If a mother has plentiful resources then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter. However, in leaner times having a daughter is a safer bet."
The study was performed in 740 nulliparous women with normal singleton pregnancies who kept a prospective food diary of their diet in early pregnancy and gave a retrospective report of their usual diet in the year prior to conception. Results showed that 56 percent of women in the highest third of preconceptional energy intake bore boys, compared with 45 percent of those in the lowest third. However, intakes during pregnancy were not associated with any gender differences, suggesting, say the authors, that the fetus does not manipulate maternal diet.
The results, the authors add, are relevant for two reasons: first, that changes in dietary habits (skipping breakfast, for example) may explain the falling proportion of male births in industrialized countries; and second, as more evidence in the debate about gender selection in fertility treatment. The latter represents a continuing ethical issue for those involved in assisted reproduction.
Gender selection in IVF has been rarely (and controversially) described for the purposes of "family balancing" and more routinely as a medical indication for couples at risk for passing on a sex-linked single gene defect to their offspring. Indeed, the first reported pregnancies following pre-implantation genetic diagnosis (PGD), from the Hammersmith Hospital in London in 1990, were in couples at risk of transmitting recessive X chromosome-linked diseases to their children. That risk was removed by the chromosomal detection of gender in each embryo (then done by polymerase chain reaction) and the transfer of only "female" embryos.
The latest report from the PGD Consortium of ESHRE (European Society of Human Reproduction and Embryology), the only group today collecting data on PGD, shows that, during the 6 years prior to the latest analysis (for 2004, with pregnancies into 2005), there were a total of 703 cycles of sexing for X-linked disease performed among the reporting centers. In 2004 alone, 113 cycles were reported, nearly all using fluorescent in situ hybridization (FISH) to identify gender.
The Consortium's 2004 analysis showed that, of the embryos successfully biopsied, 93 percent (564/608) gave a diagnostic result, of which only 32 percent (183/564) were transferable (female); only 67 percent of the started cycles (76/113) reached embryo transfer. A positive heartbeat was found in 20 cycles (18 percent), giving an implantation rate of 17 percent (20/120), rates similar to those found in previous data collections.
The same dataset also shows that, in 2004, 79 cycles of PGD were preformed for "social sexing," most of which were in couples requesting a male embryo. However, social sex selection remains controversial and the debate about its application continues. Sex selection for non-medical reasons is still prohibited in India, Europe and Australia and patients having any type of PGD are not permitted to choose embryos on the basis of gender.
The results of their study show a clear association between a high energy intake before conception and the birth of sons. As well as consuming more calories, women who had sons were more likely to have eaten a higher quantity and wider range of nutrients, such as potassium, calcium, and vitamins C, E, and B12 than women who had girls. There was also a strong correlation between women who ate breakfast cereals and the birth of male children.
The study's lead author, Dr Fiona Mathews from the University of Exeter, said: "Potentially, males of most species can father more offspring than females, but this can be strongly influenced by the size or social status of the male, with poor quality males failing to breed at all. Females, on the other hand, reproduce more consistently. If a mother has plentiful resources then it can make sense to invest in producing a son because he is likely to produce more grandchildren than would a daughter. However, in leaner times having a daughter is a safer bet."
The study was performed in 740 nulliparous women with normal singleton pregnancies who kept a prospective food diary of their diet in early pregnancy and gave a retrospective report of their usual diet in the year prior to conception. Results showed that 56 percent of women in the highest third of preconceptional energy intake bore boys, compared with 45 percent of those in the lowest third. However, intakes during pregnancy were not associated with any gender differences, suggesting, say the authors, that the fetus does not manipulate maternal diet.
The results, the authors add, are relevant for two reasons: first, that changes in dietary habits (skipping breakfast, for example) may explain the falling proportion of male births in industrialized countries; and second, as more evidence in the debate about gender selection in fertility treatment. The latter represents a continuing ethical issue for those involved in assisted reproduction.
Gender selection in IVF has been rarely (and controversially) described for the purposes of "family balancing" and more routinely as a medical indication for couples at risk for passing on a sex-linked single gene defect to their offspring. Indeed, the first reported pregnancies following pre-implantation genetic diagnosis (PGD), from the Hammersmith Hospital in London in 1990, were in couples at risk of transmitting recessive X chromosome-linked diseases to their children. That risk was removed by the chromosomal detection of gender in each embryo (then done by polymerase chain reaction) and the transfer of only "female" embryos.
The latest report from the PGD Consortium of ESHRE (European Society of Human Reproduction and Embryology), the only group today collecting data on PGD, shows that, during the 6 years prior to the latest analysis (for 2004, with pregnancies into 2005), there were a total of 703 cycles of sexing for X-linked disease performed among the reporting centers. In 2004 alone, 113 cycles were reported, nearly all using fluorescent in situ hybridization (FISH) to identify gender.
The Consortium's 2004 analysis showed that, of the embryos successfully biopsied, 93 percent (564/608) gave a diagnostic result, of which only 32 percent (183/564) were transferable (female); only 67 percent of the started cycles (76/113) reached embryo transfer. A positive heartbeat was found in 20 cycles (18 percent), giving an implantation rate of 17 percent (20/120), rates similar to those found in previous data collections.
The same dataset also shows that, in 2004, 79 cycles of PGD were preformed for "social sexing," most of which were in couples requesting a male embryo. However, social sex selection remains controversial and the debate about its application continues. Sex selection for non-medical reasons is still prohibited in India, Europe and Australia and patients having any type of PGD are not permitted to choose embryos on the basis of gender.
Tuesday, October 28, 2008
Embarassing Medical Moments
A man comes into the ER and yells, 'My wife's going to have her baby in the cab!'
I grabbed my stuff, rushed out to the cab, lifted the lady's dress, and began to take off her underwear. Suddenly, I noticed that there were several cabs -- and I was in the wrong one.
Submitted by Dr. Mark MacDonald, San Antonio , TX
At the beginning of my shift, I placed a stethoscope on an elderly and slightly deaf female patient's anterior chest wall. 'Big breaths,' I instructed. 'Yes, they used to be,' replied the patient.
Submitted by Dr. Richard Byrnes, Seattle , WA
One day I had to be the bearer of bad news when I told a wife that her husband had died of a massive myocardial infarct. Not more than five minutes later, I heard her reporting to the rest of the family that he had died of a 'massive internal fart.'
Submitted by Dr. Susan Steinberg
During a patient's two week follow-up appointment with his cardiologist, he informed me, his doctor, that he was having trouble with one of his medications. 'Which one?' I asked. 'The patch, the nurse told me to put on a new one every six hours, and now I'm running out of places to put it!' I had him quickly undress, and discovered what I hoped I wouldn't see. Yes, the man had over fifty patches on his body!
Now, the instructions include removal of the old patch before applying a
new one.
Submitted by Dr. Rebecca St. Clair, Norfolk , VA.
While acquainting myself with a new elderly patient, I asked, 'How long have you been bedridden?' After a look of complete confusion, she answered...'Why, not for about twenty years -- when my husband was alive.'
Submitted by Dr Steven Swanson, Corvallis , OR
I was caring for a woman and asked, 'So, how's your breakfast this morning?' 'It's very good, except for the Kentucky Jelly. I can't seem to get used to the taste,' the patient replied. I then asked to see the jelly, and the woman produced a foil packet labeled 'KY Jelly.'
Submitted by Dr. Leonard Kransdorf, Detroit , MI
A nurse was on duty in the emergency room when a young woman with purple hair styled into a punk rocker mohawk, sporting a variety of tattoos, and wearing strange clothing, entered. It was quickly determined that the patient had acute appendicitis, so she was scheduled for immediate surgery. When she was completely disrobed on the operating table, the staff noticed that her pubic hair had been dyed green, and above it there was a tattoo that read, 'Keep off the grass.' Once the surgery was completed, the surgeon wrote a short note on the patient's
dressing, which said, 'Sorry, had to mow the lawn.'
Submitted by RN, no name
AND FINALLY!!!...
As a new, young MD doing his residency in OB , I was quite embarrassed when performing female pelvic exams. To cover my embarrassment, I had unconsciously formed a habit of whistling softly.
The middle-aged lady upon whom I was performing this exam suddenly burst out laughing and further embarrassing me. I looked up from my work and sheepishly said, 'I'm sorry. Was I tickling you?' She replied, 'No doctor, but the song you were whistling was, 'I wish I was an Oscar Meyer Wiener.'
Doctor wouldn't submit his name (Can't blame him!)
I grabbed my stuff, rushed out to the cab, lifted the lady's dress, and began to take off her underwear. Suddenly, I noticed that there were several cabs -- and I was in the wrong one.
Submitted by Dr. Mark MacDonald, San Antonio , TX
At the beginning of my shift, I placed a stethoscope on an elderly and slightly deaf female patient's anterior chest wall. 'Big breaths,' I instructed. 'Yes, they used to be,' replied the patient.
Submitted by Dr. Richard Byrnes, Seattle , WA
One day I had to be the bearer of bad news when I told a wife that her husband had died of a massive myocardial infarct. Not more than five minutes later, I heard her reporting to the rest of the family that he had died of a 'massive internal fart.'
Submitted by Dr. Susan Steinberg
During a patient's two week follow-up appointment with his cardiologist, he informed me, his doctor, that he was having trouble with one of his medications. 'Which one?' I asked. 'The patch, the nurse told me to put on a new one every six hours, and now I'm running out of places to put it!' I had him quickly undress, and discovered what I hoped I wouldn't see. Yes, the man had over fifty patches on his body!
Now, the instructions include removal of the old patch before applying a
new one.
Submitted by Dr. Rebecca St. Clair, Norfolk , VA.
While acquainting myself with a new elderly patient, I asked, 'How long have you been bedridden?' After a look of complete confusion, she answered...'Why, not for about twenty years -- when my husband was alive.'
Submitted by Dr Steven Swanson, Corvallis , OR
I was caring for a woman and asked, 'So, how's your breakfast this morning?' 'It's very good, except for the Kentucky Jelly. I can't seem to get used to the taste,' the patient replied. I then asked to see the jelly, and the woman produced a foil packet labeled 'KY Jelly.'
Submitted by Dr. Leonard Kransdorf, Detroit , MI
A nurse was on duty in the emergency room when a young woman with purple hair styled into a punk rocker mohawk, sporting a variety of tattoos, and wearing strange clothing, entered. It was quickly determined that the patient had acute appendicitis, so she was scheduled for immediate surgery. When she was completely disrobed on the operating table, the staff noticed that her pubic hair had been dyed green, and above it there was a tattoo that read, 'Keep off the grass.' Once the surgery was completed, the surgeon wrote a short note on the patient's
dressing, which said, 'Sorry, had to mow the lawn.'
Submitted by RN, no name
AND FINALLY!!!...
As a new, young MD doing his residency in OB , I was quite embarrassed when performing female pelvic exams. To cover my embarrassment, I had unconsciously formed a habit of whistling softly.
The middle-aged lady upon whom I was performing this exam suddenly burst out laughing and further embarrassing me. I looked up from my work and sheepishly said, 'I'm sorry. Was I tickling you?' She replied, 'No doctor, but the song you were whistling was, 'I wish I was an Oscar Meyer Wiener.'
Doctor wouldn't submit his name (Can't blame him!)
Monday, October 27, 2008
No more Baby Manjis in India, draft law on Surrogacy ready
New laws to regulate assisted reproductive technology in India will be introduced to Parliament later this year. The text of the Assisted Reproductive Technology (Regulation) Bill 2008 was published last month by the Indian Council of Medical Research (ICMR) for public comment. The bill aims to regulate surrogacy arrangements in the country where regulation is lacking, in addition to other technologies including pre-implantation genetic diagnosis (PGD) and research on embryos.
The bill will set up a National Advisory Board for Assisted Reproductive Technology to oversee the delivery of the services in the country. A regulatory body, the Registration Authority, will grant licences to fertility clinics to store gametes and offer fertility services. Embryo research must be performed on embryos donated for research and not stored beyond 14 days. Researchers must apply for a licence from the Registration Authority to perform research on embryos. The bill will also make it a criminal offence to perform sex-selection procedures except to prevent or treat a sex-linked disorder or disease.
Media reports last August about a baby girl, Manyi Yamada, showed inadequacies in India's regulation of surrogacy, which was legalised in 2002. Manyi was born to an Indian surrogate mother, but the Japanese couple who arranged the surrogacy split up prior to the birth of the child. The child's biological father sought parental rights over the child but Indian laws were not clear on the status of foreign parents involved in surrogacy arrangements within its borders and the matter had to be decided in the
courts. The new bill will clarify this area by making a surrogate child the legitimate child of a separated or divorced couple. Foreigners seeking surrogacy arrangements in the country will be required to register with their embassy and will have to state with whom the child should be looked after in the event of one of the parent's death. Following surrogacy, the child's birth certificate will show the names of both genetic parents. The bill also forbids women under 21 from entering into surrogacy arrangements and from having more than three live births in their lifetime. Once a surrogate child attains the age of 18, they may apply for information about their surrogate parent.
India's Health Ministry does not keep official statistics on the number of surrogate births in the country but it is believed to be low. Media reports suggest that surrogacy arrangements in India can attract surrogate fees of between $12,000 to $30,000, with the industry being worth around $445m. The bill does not ban offering surrogate mothers compensation for their services. Dr P M Bhargava, a member of the ICMR who helped draft the bill, told the Times of India that, 'considering all the news about surrogacy, including the recent case of the Japanese child, we realised that the new law addresses all the problem areas'.
The bill was timetabled to be debated by the Indian Parliament in the winter session. It met with stiff opposition from the Medical community and will be now reviewed by the Indian Law Ministry.
The bill will set up a National Advisory Board for Assisted Reproductive Technology to oversee the delivery of the services in the country. A regulatory body, the Registration Authority, will grant licences to fertility clinics to store gametes and offer fertility services. Embryo research must be performed on embryos donated for research and not stored beyond 14 days. Researchers must apply for a licence from the Registration Authority to perform research on embryos. The bill will also make it a criminal offence to perform sex-selection procedures except to prevent or treat a sex-linked disorder or disease.
Media reports last August about a baby girl, Manyi Yamada, showed inadequacies in India's regulation of surrogacy, which was legalised in 2002. Manyi was born to an Indian surrogate mother, but the Japanese couple who arranged the surrogacy split up prior to the birth of the child. The child's biological father sought parental rights over the child but Indian laws were not clear on the status of foreign parents involved in surrogacy arrangements within its borders and the matter had to be decided in the
courts. The new bill will clarify this area by making a surrogate child the legitimate child of a separated or divorced couple. Foreigners seeking surrogacy arrangements in the country will be required to register with their embassy and will have to state with whom the child should be looked after in the event of one of the parent's death. Following surrogacy, the child's birth certificate will show the names of both genetic parents. The bill also forbids women under 21 from entering into surrogacy arrangements and from having more than three live births in their lifetime. Once a surrogate child attains the age of 18, they may apply for information about their surrogate parent.
India's Health Ministry does not keep official statistics on the number of surrogate births in the country but it is believed to be low. Media reports suggest that surrogacy arrangements in India can attract surrogate fees of between $12,000 to $30,000, with the industry being worth around $445m. The bill does not ban offering surrogate mothers compensation for their services. Dr P M Bhargava, a member of the ICMR who helped draft the bill, told the Times of India that, 'considering all the news about surrogacy, including the recent case of the Japanese child, we realised that the new law addresses all the problem areas'.
The bill was timetabled to be debated by the Indian Parliament in the winter session. It met with stiff opposition from the Medical community and will be now reviewed by the Indian Law Ministry.
Subscribe to:
Posts (Atom)