Harnessed stem cells bring hope for infertile
According to a report, the years-long belief that women are born with all their eggs is false.1 Harvard scientists believe they've discovered the ovaries of women harbor rare stem cells that are able to create new eggs. Being able to harness those stem cells is good news for women who are infertile but wish to have children.
The research, led by Jonathan Tilly, PhD, chief, MGH Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, extracted human stem cells that could become immature eggs because all carry a unique protein called DDX4.
These spontaneously generated into immature eggs, called oocytes, in the laboratory. Using live ovarian tissue grafted into mice, these cells were made to mature into egg cells.
While the findings have yet to be applied to humans, it is believed that the study could represent a major breakthrough for fertility treatments. The results could be used to develop new therapies that might benefit older women or infertile women.
For technical, ethical, and legal reasons, the researchers weren't able to test whether the human DDX-expressing cells could generate viable embryos. Nonetheless, they state, "we have established a consistent and close parallelism between human ovary-derived DDX4-positive cells and mouse OSCs in terms of strategy of purification, yield from adult ovary tissue, morphology, primitive germline gene expression profile, in vitro growth properties, mitotic activity, meiotic activity, and the ability to form oocytes in defined cultures in vitro and in injected ovary tissue in vivo.
"We feel it is reasonable to conclude that the rare cells with cell-surface expression of DDX4 that are present in the ovaries of reproductive-age women represent adult human OSCs," the authors conclude. "In addition to opening a new research field in human reproductive biology that was inconceivable less than 10 years ago, clear evidence for the existence of these cells in women may offer new opportunities to expand on and enhance current fertility-preservation strategies."
- Tilly J, White Y, Woods D, et al. Oocyte formation by mitotically active germ cells purified from ovaries of reproductive-age women. Nature Medicine 2012;18:413-421.
School vending machine offers morning after pill
Students at Shippensburg (PA) University can receive the Plan B One Step emergency contraceptive right out of a vending machine on campus. The vending machine also dispenses condoms, decongestants, and pregnancy tests.
After the vending machine made local news reports, federal authorities began investigating Shippensburg University's use of a vending machine to dispense morning-after pills to students.
The FDA's probe is to determine whether the school vending machine is in line with a federal requirement that any female under age 17 have a prescription for the drug, which is used after unprotected sex. Normally, Plan B emergency contraception is kept behind the counter so a pharmacist can check ID.
The decision to use a vending machine was made after school officials determined no one enrolled at Shippensburg is younger than 17, Roger Serr, PhD, vice president for student affairs, said in a statement. Serr also said the vending machine's presence on the campus is not a green light for sexual activity on campus.
An FDA spokeswoman said in a statement, "We are working to gather the facts now, including contacting Pennsylvania state authorities and the university."
Pope says IVF is unethical
Pope Benedict XVI's call for more research into ethical treatments for infertility as an alternative to in vitro fertilization (IVF) is being applauded by a leading Catholic bioethicist.
"The pope is quite right when he says that IVF is a profit-making business; they make a lot of money, and their success rates are not great," Edward Furton, PhD, editor with the National Catholic Bioethics Center, Philadelphia, PA, told the Catholic News Agency. "The profit motive here is not good," he said. "There are lesser known, more ethical, more effective methods which are being ignored because these labs are making money telling couples that IVF is the best or only option."
Pope Benedict made his remarks at a workshop hosted by the Pontifical Academy for Life to discuss ethically treating infertility. He said he is concerned that the field of human procreation seems to be dominated "by scientism and the logic of profit," which often "restricts many other areas of research."
The pope said that "research into diagnosis and therapy is the most scientifically correct approach to the question of infertility, as well as being the most respectful of the human condition of the people involved."
He also underscored the Catholic position that IVF is an unethical means of treating infertility and that "that community of love and life which is marriage, represents the only worthy 'place' for a new human being to be called into existence."
The Catholic Church also objects to the destruction of human embryos during IVF treatment. The pope called for treatments that are the "expression of the concrete possibility of fruitful dialogue between ethics and biomedical research."
Quality measures endorsed for EOL, palliative care
The National Quality Forum (NQF) is endorsing 14 quality measures on palliative and end-of-life (EOL) care focused on addressing care management concerns.
"As the number of palliative and end-of-life care programs continue to grow across the country, it's critical that providers have the right measurement tools to help ensure patients receive safe, high-quality, and compassionate care," said June Lunney, PhD, RN, in a statement announcing the measures. Lunney serves as the director of research at the Hospice and Palliative Nurses Association and as co-chair of the Palliative Care and End-of-Life Care Endorsement Maintenance Steering Committee at NQF.
The endorsed measures include 12 new measures and two previously endorsed measures. The measures cover pain management, psychosocial needs, care transitions, and experiences of care.
"As the number of older adults in this country continues to grow, palliative and end-of-life care services are needed more than ever," said Janet Corrigan, PhD, president and CEO of NQF, in a statement. "This set of measures will help promote the type of high-quality care older people and acutely ill patients deserve."
Integrative medicine effective in treating illness
A survey of 29 integrative medicine centers around the United States found that 75% reported success using integrative practices to treat chronic pain and more than half reported positive results for gastrointestinal conditions, depression and anxiety, cancer, and chronic stress.
The results of the survey, Integrative medicine in America: How integrative medicine is being practiced in clinical centers across the United States, are being released by The Bravewell Collaborative in Minneapolis, which develops and manages strategic initiatives that support integrative approaches to healthcare.
"What we have seen in our clinics over the past 14 years is that more and more people are turning to integrative therapies to help them with health problems," says William Stewart, MD, the co-founder and medical director of California Pacific Medical Center's Institute for Health and Healing (IHH), San Francisco. "This survey shows that for many patients, particularly those with chronic health issues, the multidimensional team approach of integrative medicine works."
Donald Abrams, MD, co-author of the report and professor of clinical medicine at the University of California San Francisco, says, "With chronic health issues costing the U.S. economy more than $1 trillion a year, it's essential to find the most effective ways to treat and prevent the most prevalent conditions,"
Twenty-nine integrative medicine centers were surveyed by The Bravewell Collaborative. All participating centers were affiliated with hospitals, health systems, and/or medical and nursing schools. Patient services included adult care, geriatric care, adolescent care, OB-GYN care, pediatric care and end-of-life care. Findings from the report, which evaluated trends in prevention and wellness, patient outcomes, and emerging norms of care and reimbursement, suggest that the practice of integrative medicine offers promise for increasing the effectiveness of care and improving people's health.
The interventions prescribed most frequently by practitioners in the study, usually in combination, were: food/nutrition, supplements, yoga, meditation, traditional Chinese medicine/acupuncture, massage and pharmaceuticals.
"It's important to remember that these therapies are often used in conjunction with other medical approaches, such as chemotherapy and/or surgery," says Stewart. "At the IHH we work with each patient and their other caregivers to come up with an approach that is best suited for them. Our care integrates traditional and contemporary healing practices."
- Integrative medicine in America: How Integrative medicine is being practiced in clinical centers across the United States. Web: http://bit.ly/yXpBHc.
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