Category: Reproductive Health

A First: Uterine Transplant from Deceased Donor Allows for Live Birth

Innovation within the field of organ transplantation has grown tremendously in the past decade. Amongst this progress is a new story of success from São Paolo, Brazil.

A new study, revealed that for the first time ever, a baby was delivered via a uterus which had been transplanted from a deceased donor. The mother had an abnormality which rendered her infertile, and resultantly needed a transplanted uterus in order to conceive and give birth. This has been done before with living donors, but never had it been done with a deceased donor. The mother delivered the baby in c-section to a health newborn baby. Now, almost a year later, the child has continued to live a healthy, normal life.

This example is especially unique because of the donor. When transplanting from a deceased donor, there are always several hours of transport and surgery which leave the organ without oxygen. In this case, the uterus went without oxygen for nearly 8 hours. Dr. Andrew Shennan, an obstetrics professor at Kings College London noted the rareness and importance of this case in particular. This study demonstrated that the uterus can remain functioning and intact despite this 8-hour period. This information is invaluable, and can inform other operations in the future.

 

https://www.cnn.com/2018/12/04/health/uterus-transplant-deceased-donor-study/index.html

 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31766-5/fulltext

 

https://www.kcl.ac.uk/lsm/newsevents/newsrecords/2018/Jan/New-Years-Honours.aspx

 

December 1st is World AIDS Day

Yesterday was World AIDS Day, a global event that takes place each year on December 1st to raise awareness about HIV/AIDS, to honor those who have died from AIDS-related illness, and to show support for those living with HIV.

Globally, we have made advances in addressing the HIV/AIDS epidemic. New HIV infections have decreased by 47% since 1996, and deaths from AIDS-related illnesses have fallen more than 51% since 2004. We have made advances in HIV testing and prevention as well as antiretroviral treatment. Pre-exposure antiretroviral prophylaxis or “PrEP” has been shown to be an effective form of HIV prevention. PrEP is a pill that, when taken consistently, can reduce HIV infection risk in high-risk individuals by up to 92%. And when used with other HIV prevention methods such as using condoms, can offer even more protection. In 2015, the World Health Organization recommended use of pre-exposure antiretroviral prophylaxis or “PrEP” for high-risk individuals to prevent HIV.

However, while we have made tremendous progress in understanding the HIV virus and how to both treat and prevent it, there is still more to be done. About one in four people with HIV do not know they are infected. 1.8 million people are newly infected each year with HIV, any people across the globe lack access to the critical HIV prevention and care that they need to live long, healthy lives.

To learn more about HIV and how you can support people living with the virus, please visit the following resources:

CDC: About HIV/AIDS | https://www.cdc.gov/hiv/basics/whatishiv.html

HIV.gov | https://www.hiv.gov/

HIV/AIDS World Health Organization | http://www.who.int/hiv/en/

San Francisco AIDS Foundation | http://www.sfaf.org/hiv-info/

References

Centers for Disease Control and Prevention. (2018, November 1). Pre-exposure Prophylaxis (PrEP). Retrieved from https://www.cdc.gov/hiv/risk/prep/index.html

Kaiser Family Foundation. (2018, July 25). The Global HIV/AIDS Epidemic. https://www.kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/

National AIDS Trust: World AIDS Day. (2018). About World AIDS Day. https://www.worldaidsday.org/about/

UNAIDS. (2018). Global HIV & AIDS statistics  – 2018 fact sheet. Retrieved from http://www.unaids.org/en/resources/fact-sheet

U.S. Department of Health and Human Services. (2018, November 20). Global Statistics. Retrieved from https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics

World Health Organization. (2015). Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV, web supplement: annex 2: evidence to decision-making tables and supporting evidence (No. WHO/HIV/2015.36). World Health Organization.

World Health Organization. (N.d.). WHO and HIV: 30-Year Timeline. Retrieved from http://www.who.int/hiv/mediacentre/news/WAD_Timeline.jpg

Health and the midterm elections

Today is election day. Across the country there are numerous elections which are weighing in on important health issues. There are several important health topics in the ballots, including: abortion rights, Medicaid expansion, marijuana usage, grocery taxes, and laws related to drug use and possession charges. Due to the political leanings of the current national administration, abortion rights are particularly vulnerable during this time.

Alabama, West Virginia, and Oregon are voting on legislation which will seriously affect access to abortion. On Alabama’s ballot, a newly proposed Amendment 2 is trying to change the wording which defines a fetus’ rights on the state Constitution. The amendment is aiming to grant a fetus the same rights and protections as a baby who has been born. If passed, this issue could have serious implications on further legislation which may eventually outlaw abortion in the state. In addition, this ballot measure doesn’t include the right to an abortion in the case of rape, incest, or if the mother’s life is at-risk.

West Virginia and Oregon are voting on measures which attempt to withhold state funding for abortion cases in respect to state employees and Medicaid recipients. However, in contrast to Alabama’s measure, these states do grant the right to victims of rape, incest, or when the mother’s life is in danger.

It is important to consider how our votes can act as determinants for health issues like these and many others. Voting at a state level can have a much larger impact on both national and local issues – especially pertaining to public health and medicine. Go out and vote today!

Look up your registration status, local polling place, and sample ballot here:

https://vt.ncsbe.gov/RegLkup/

 

 

https://www.cnn.com/2018/11/05/health/health-ballot-initiatives/index.html

https://ballotpedia.org/Alabama_Amendment_2,_State_Abortion_Policy_Amendment_(2018)

 

meet the new, self-lubricating condom

It’s no secret that the U.S. still has a long way to go in the field of contraceptives and STI prevention. According to the CDC in 2017, only about one-third of sexually active Americans use condoms, and it has been a long-term public health issue. Abstaining from condom use (or other forms of protection) during sex can lead to a myriad of health concerns, including unwanted pregnancies, bacterial and viral infections. These new troubling statistics beg questions as to why condom use is so low, especially amongst those who aren’t opting for other birth control or protective options.

Scientists at Boston University have acknowledged this issue, and have responded with a new, friction-lowering self-lubricating condom that may up condom usage. Some of the reasons people abstain from use is due to complaints that condoms are uncomfortable, painful and detract from sensation and sexual pleasure. The team at BU has found a way to eliminate some of these negative qualities with their new technology. This new condom has the ability to self-lubricate when it comes into contact with moisture – such as bodily fluids – making sexual experiences more comfortable and enjoyable.

Their study showed that 73% individuals surveyed preferred the texture of their new condom, and also noted that they would be more inclined to use condoms such as this one. The condom still has to be tested during sex, but if introduced to the market, it could increase the prevalence of safe-sex behaviors and contraceptive use.

 

 

 

https://www.cdc.gov/nchs/data/nhsr/nhsr105.pdf

https://consumer.healthday.com/sexual-health-information-32/condom-health-news-154/only-about-one-third-of-americans-use-condoms-cdc-725436.html

https://www.cnn.com/2018/10/17/health/condoms-self-lubricating-prevent-stds-intl/index.html

http://journals.sagepub.com/doi/abs/10.1258/ijsa.2008.008120?journalCode=stda

http://rsos.royalsocietypublishing.org/content/5/10/180291

 

 

 

 

Dr. Leana Wen Selected as New President of Planned Parenthood

Last week, it was announced that Dr. Leana Wen, Baltimore City Health Commissioner, will serve as the new president of Planned Parenthood Federation of America, an organization that provides vital sexual and reproductive health care and education to millions of people around the world. Dr. Wen will be the first physician in almost 50 years to serve in this role. She will succeed Cecile Richards, who has served as president of Planned Parenthood for the past 12 years.

Dr. Wen, an emergency medicine physician, has led the Baltimore City Health Department since January 2015. She is a passionate public health leader and active champion for communities and patients. During her tenure as Baltimore City Health Commissioner, Dr. Wen led a lawsuit against the Trump administration after its abrupt decision to cut funding for teen pregnancy prevention programs, resulting in $5 million of funding being restored to two of these programs in Baltimore. Additionally, Dr. Wen has fought to preserve Title X in Baltimore, which funds a variety of health care services for low-income women.

Dr. Wen is no stranger to Planned Parenthood. After she and her family immigrated to the U.S. from China, they depended on Planned Parenthood for their health care. Dr. Wen also volunteered at a Planned Parenthood health center in St. Louis during medical school.

In a recent statement posted on the Baltimore City Health Department website, Dr. Wen wrote:

“A core principle in public health is to go where the need is. The single biggest public health catastrophe of our time is the threat to women’s health and the health of our most vulnerable communities.”

She continues, in referring to Planned Parenthood, writing:

“I have seen firsthand the lifesaving work it does for our most vulnerable communities. As a doctor, I will ensure we continue to provide high-quality health care, including the full range of reproductive care, and will fight to protect the access of millions of patients who rely on Planned Parenthood.”

Dr. Wen’s last day as Baltimore City Health Commissioner will be Friday, October 12th, where she will then begin her new role as President of Planned Parenthood.

References:

Planned Parenthood. (N.d.). Dr. Leana Wen. Retrieved from  https://www.plannedparenthood.org/about-us/our-leadership/dr-leana-wen

Planned Parenthood. (N.d.). Cecile Richards. Retrieved from  https://www.plannedparenthood.org/about-us/our-leadership/cecile-richards

Zernike, Kate. (2018, September 12). Planned Parenthood Names Leana Wen, a Doctor, Its New President. Retrieved from https://www.nytimes.com/2018/09/12/us/politics/planned-parenthood-president-wen.html?rref=collection%2Fsectioncollection%2Fpolitics

Wen, Leana S. (2018, July 6). Trump’s family planning dystopia. Retrieved from http://www.baltimoresun.com/news/opinion/oped/bs-ed-op-0708-wen-dystopia-20180703-story.html

Baltimore City Health Department. (2018, September 12). Statement from Baltimore City Health Commissioner, Dr. Leana Wen. Retrieved from https://health.baltimorecity.gov/news/press-releases/2018-09-12-statement-baltimore-city-health-commissioner-dr-leana-wen

Soot Happens

A new study released from the Queen Mary University of London has shown for the first time that air pollution exposure can affect a pregnant woman’s placenta. The placenta is a vital organ which develops during a woman’s pregnancy. It is responsible for providing nutrients and oxygen to a developing baby. In addition, it also serves as an immune system barrier for the baby, which is vulnerable during pregnancy. Any injuries inflicted on the placenta can have serious health effects on the unborn child.

The Queen Mary study examined placenta cells of five women who were exposed to air pollution. Within the samples, researchers found evidence of the presence of soot. Soot is a common air pollutant classified as particulate matter. This type of pollution is made of large damaging particles, and can often be found coming from power plants, manufacturing sites, and motor vehicles. Soot exposure is dangerous, and it is the cause of thousands of premature deaths annually. The findings of this study are novel and alarming – it demonstrates that inhaled particulate matter can travel from the lungs to the placenta.

Placental immune cells are necessary to keep an unborn baby healthy. If the placental immune system is compromised, so is that of the growing baby. It is still unclear what this study’s findings mean for fetal-placental health in the long term. However, researchers on this study are particularly concerned about how soot exposure may disrupt this system.

One thing is clear – this news is disturbing. The study demonstrated that air pollution damage does not stop at the lungs. The conversation about air pollution is not always an environmental one; many pollutants like soot affect human health dramatically. Going forward, it is important to consider how these findings should influence policy. Regulating air pollution is a necessary step to take in order to protect the health of people worldwide.

 

 

https://www.momscleanairforce.org/soot-facts/

https://www.qmul.ac.uk/media/news/2018/smd/first-evidence-that-soot-from-polluted-air-may-be-reaching-placenta.html

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/placenta/art-20044425

https://www.nichd.nih.gov/research/supported/HPP/default

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025805/

 

 

What you need to know about SESTA and the recent seizure of Backpage

Late last week, classified ad website Backpage.com went offline after being seized and disabled due to an “enforcement action by the Federal Bureau of Investigation, the U.S. Postal Inspection Service, and the Internal Revenue Service Criminal Investigation Division”. Backpage.com is known for personal ads, and was considered by many to be the dominant online platform for sex workers to advertise their services.

Various websites have been shutting down their personal ads section in response to the Stop Enabling Sex Trafficking Act (SESTA), which has taken aim at online platforms as a playing a perceived role in sex trafficking and prostitution. While many advocates have been fighting SESTA for a large part of the year, awareness seems to be low of the laws implications among the general population.

Advocates against SESTA argue that the act will do more harm than good in regards to the safety of sex workers. Online platforms for sex work have been viewed as safer than street based sex work, allowing for screening of potential clients. Others have argued that SESTA would limit online free speech, arguing that it would require platforms to put strong restrictions on users’ speech, extending beyond the space of personal ads. If you’re interested in seeing what you can do stop SESTA, check out https://stopsesta.org for more information on how to contact your elected officials.

 

Sources – Buzzfeed News: Backpage Has Been Taken Down By The US Government And Sex Workers Aren’t Happy – https://www.buzzfeed.com/blakemontgomery/backpage-service-disruption?utm_term=.mceyodXp#.bkjAQmNK

“The Angelina Effect”

In this day of age celebrities dominate our world. They hold elected office, they are activists, they are social media entrepreneurs, they are everywhere. Whether we like to believe it or not they have influence over our behaviors and how we make decisions. I’m guilty that most of the accounts I follow on Instagram are former Bachelor contestants and catch myself wanting to mimic their fashion and fitness routines. In fact, there has been research that has examined this phenomenon. Back in 2013, esteemed actress Angelina Jolie announced that she carries the a genetic mutation that greatly increases your risk of breast and ovarian cancer (BRCA1). In her New York Times opt ed piece, Jolie reveals that she lost her mom, aunt and grandmother to cancer and that influence her decision to undergo preventive surgery to remove both of her breasts (mastectomy) and ovaries. After this announcement, several researchers explored what came to be known as “The Angelina Effect” and how her decision influenced other women’s decisions about their own health. In a study published in Health Services Research journal, hospital data from both New York and the UK revealed that three months after Jolie’s announcement there was a significant increase in preventive mastectomies prior to the announcement. This trend has been seen with other celebrities after announcements of diagnoses and provides incentives for both public figures and healthcare providers to use these instances as teachable moments and bring awareness to employ preventive healthcare.

To learn more about the BRCA1 gene visit the following site: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1

 

 

 

Pollution and Pregnancy: A Match Made in Hell

A recent study in the journal Biological Psychiatry has found that mothers exposed to air pollution during pregnancy have children at higher risk of cognitive health problems, due to brain alteration during fetal development. Such abnormalities resulted in issues such as impulse control and behavioral problems. Researchers believe that long-term impacts could include high-risk activity, such as addiction, as well as mental health disorders and low academic achievement.

Previous research has associated high levels of pollution with poor development in the womb, but this study found that these risks occur even when pregnant mothers were living in places with air pollution levels deemed acceptable. This raises questions of whether our air quality measurement standards are adequate and accurate.

Researchers compare this troubling finding with the field’s existing knowledge of the dangers of smoking during pregnancy – Dr. John Krystal, editor of the journal that published the study, draws the parallel that both scenarios involve “inhaling toxins.” We already know that other environmental factors (like stress, lead exposure, and pesticides) can lead to adverse outcomes during pregnancy, but it seems that regulatory policies for some environmental risks fall short of others. Translating research findings to the public – and focusing on productive solutions instead of instilling fear in those with no choice of residence – are key roles for public health moving forward.

Sources:

https://www.usnews.com/news/national-news/articles/2018-03-14/air-pollution-within-levels-considered-safe-changes-brain-development-leads-to-cognitive-impairment

http://time.com/3757864/air-pollution-babies/

http://www.biologicalpsychiatryjournal.com/article/S0006-3223(18)30064-7/fulltext

Achieving Health Equity and Justice through the Reproductive Justice Framework: keynote by Monica Raye Simpson

This past Friday marked the 39th annual Minority Health Conference, which is the largest and longest run student-led health conference in the world. This year’s 20th annual William T. Small Jr. keynote speaker was Monica Raye Simpson, who is the executive director of SisterSong Women of Color Reproductive Justice Collective, gave a keynote address titled: “Achieving Health Equity and Justice through the Reproductive Justice Framework”. In the talk, Simpson gave an energetic and powerful where she gave a history of the Reproductive Justice framework, and how her own life experiences shaped how she approaches her work. One of her main points was how the Reproductive Justice Framework’s focus on centering those who are the most marginalized is critical for the field of Public Health, in order to overcome health inequities. In case you were not able to attend the event in person, the keynote speech is available for broadcast in the link below, moderated by yours truly.

Sources: https://sph.unc.edu/sph-webcast/2018-02-23_mhc/