Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Sunday, June 25, 2017

Overdose Capital of the U.S.

"Heroin is the devil's drug, man. It is."
"No one wants their family to find them face down with a needle in their arm."
"But no one stops until they're ready."
Cliff Parker, 24, heroin user, Akron, Ohio

"July 5, 2016 -- that's the day carfentanil hit the streets of Akron."
Captain Michael Shearer, commander, Narcotics Unit, Akron Police Department
ohio seizure
Drugs seized by Montgomery County (Ohio) Sheriff's officers  (Montgomery Sheriff's Office)

Akron, Ohio got their initiation into the devastating effects of a powerful sedative used to sedate huge beasts like elephants, when it appeared on their streets likely sourced from China through the Internet and being used to adulterate more expensive drugs for higher profitability. People using illicit street drugs looking for a kick, and a high more dramatic than the ones they'd become accustomed to and were dissatisfied with, began to get more than they'd bargained for.

On the day that Captain Shearer was commemorating with huge regret, 17 people overdosed, with one of them dying over a tortuous nine hours. The following six months saw 140 overdose deaths of people testing positive for carfentanil, verified by the county medical examiner. With fentanyl, the still-highly-dangerous but more moderate of the two drugs and carfentanil, overdoses can present as sufficiently severe that even multiple doses of naloxone -- the anti-overdose medication -- can barely rescue people from death.

Fentanyl has been around for awhile. Its legitimate use in the medical community is that of a pain reliever. It is commonly prescribed in amounts carefully judged by those skilled in pain management for people suffering pain. It is also used in hospital settings during surgery and following surgery to help manage the pain that accompanies surgical intervention and its follow-up recovery. As such its use is monitored and carefully gauged and stopped once its work is deemed to have succeeded.

But it is also a drug that has been seen more and more frequently during drug seizures over the past three years across North America. Most frequently fentanyl is sold as heroin on the street. Alternately drug traffickers make use of it to produce cheap counterfeit prescription opioids. Its cousin carfentanil is 5,000 more powerful than heroin, and it is well known that a few grains of the drug can be lethal.

Lisa Roberts
Lisa Roberts gives a naloxone auto-injecter to a group of women who live under a bridge in Portsmouth, Ohio. (Jon Castell/CBC)
So much so that the requirement of multiple applications of naloxone to save a life has become common. Rescue crews (first-responders) "are hitting them with 12, 13, 14 hits of Narcan with no effect", observed Doyle Burke, the chief investigator at the Warren County coroner's office in Ohio. And this situation is only  going to become more common, with overdose deaths continuing to spiral upward, according to Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention.

As Dr. Frieden points out, this represents the sole aspect of American health becoming significantly worse over accelerated time. In excess of two million Americans are thought to be dependent on opioids, with another 95 million who used prescription painkillers in the past year. "This epidemic, it's got no face", commented Chris Eisele, president of the Warren County Fire Chiefs' Association. Lawyers, accountants, young adults and teens from middle-class backgrounds attend Narcotics Anonymous meetings in Deerfield Township.

There has been 312 drug deaths in Summit County in 2016 alone, a 45 percent increase from 2015, and over triple the 99 cases that the medical examiner's office saw just two years earlier. Last year -- according to Gary Guenther, chief investigator of the county medical examiner's office -- saw so many deaths that the county was forced to have refrigerated trailers brought onto site to store bodies when the morgue had run out of space, on three occasions.
"The problem is getting worse every day. We don’t have enough police resources to combat it. We work very hard, it’s changed our jobs."
"We’re trying to be proactive. People say to us: ‘We didn’t know, we don’t understand’ the scope of the crisis."
"I don’t know, with everything that’s out there, how some people still don’t know [about the epidemic]."
"They're overdosing in the jails and in courtrooms."
Montgomery County Sheriff Phil Plummer
Public health nurse Lisa Roberts leads Project DAWN, the first program in Ohio to put the anti-overdose drug naloxone into the hands of users.
Public health nurse Lisa Roberts leads Project DAWN, the first program in Ohio to put the anti-overdose drug naloxone into the hands of users. (Jon Castell/CBC)

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Saturday, June 24, 2017

On The Cancer Front....

"Currently, every year we're seeing an increase in the number of cancer cases in Canada. So between now and 2030, for example, we expect to continue to see a dramatic increase in the number of cancers diagnosed in Canada."
"That is a reflection of the growing and aging population. About 90  percent of all the cancers that we expect to be diagnosed in 2017 will be among Canadians 50 years of age and older."
"Declines in death rates have been largely driven by decreases in lung cancer incidence and mortality. So tobacco control in general has had a big impact on our death rates."
Leah Smith, epidemiologist, Canadian Cancer Society
Canadian Cancer Society logo

Four cancers -- prostate, breast, lung and colorectal -- remain top of the list reflecting the most common cancer malignancies to strike Canadians. Those four types of cancer account for over half of the diagnoses of cancer and the trend continues into 2017. More people are expected to die of lung cancer than any other cancer, an anticipated number of 21,100 for 2017, representing more deaths from one cancer alone than the other three top-listed cancers in combination (19,200).

Approximately 45 percent of newly diagnosed cases occur in that segment of the population aged 70 and older, according to Ms. Smith. As greater numbers of the population age, so does the number of diagnoses of cancer rise. Cancer is projected to cause death to roughly one in four Canadians. Yet mortality rates have been steadily declining from the time in 1988 when deaths due to cancer were at their peak.

That decline is largely attributable to screening for cancer performed at an increased rate, along with improved treatment, adding up to larger survival rates among women. There are not many families who have missed an acquaintanceship with this dread disease, either from one close, or a number of distant members being diagnosed. And some unfortunate families have been deluged with an incidence of diagnoses that seems to hit just about everyone in the family.

In one family alone an aunt died of breast cancer, and when her niece became a new mother her husband developed osteosarcoma requiring a bone transplant and "dramatic" bouts of chemotherapy. Three uncles then succumbed to lung cancer as a result of lifelong smoking habits. And then the woman's father developed fatal colon cancer. After which her brother was diagnosed with skin cancer. The woman herself was diagnosed then with breast cancer. And then her mother had a soft-tissue sarcoma, dying two years after diagnoses.

Still, survival rates are increasing for some cancers in particular, quite dramatically. Of Canadians diagnosed and treated for cancer, some 60 percent will survive five years or longer. With the exception of pancreatic cancer which has an eight percent, five-year survival rate, representing the most negative prognosis of the 23 malignancies reported on by the Canadian Cancer Society. An estimated 5,500 Canadians will be diagnosed with cancer of the pancreas, of whom 4,800 will die of the disease.

It is estimated that in 2017:
  • 103,100 Canadian men will be diagnosed with cancer and 42,600 men will die from cancer.
  • 103,200 Canadian women will be diagnosed with cancer and 38,200 women will die from cancer.
  • On average, 565 Canadians will be diagnosed with cancer every day.
  • On average, 221 Canadians will die from cancer every day.
Lung, breast, colorectal and prostate cancer are the most common types of cancer in Canada (excluding non-melanoma skin cancer). Based on 2017 estimates:
  • These cancers account for half (50%) of all new cancer cases.
  • Prostate cancer accounts for about one-fifth (21%) of all new cancer cases in men.
  • Lung cancer accounts for 14% of all new cases of cancer.
  • Breast cancer accounts for about one-quarter (25%) of all new cancer cases in women.
  • Colorectal cancer accounts for 13% of all new cancer cases.  Canadian Cancer Society logo

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Friday, June 23, 2017

The Globe's Foremost Apex Marine Predator

"We've been chased out of the Bering Sea. [Electronic noisemakers to frighten them off?] It became a dinner bell."
"It's possible at some point they [Orcas] might start hitting the pot [conversion to giant fishing traps called pots]."
"When I started fishing in the early '80s, when we saw a whale it was an event. Now, they circle the boat."
Paul Clampitt, co-owner F/V Augustine, Washington State

"[Orca pods close to the Aleutian Islands are like a] motorcycle gang."
"You'd see two of them show up, and that's the end of the [fishing] trip. Pretty soon all forty of them would be around you."
"[Pulling up lines to see some fish merely gnawed] That was them teaching the little ones. It's unfortunate the orcas are putting us out of business, because they're really a phenomenal mammal."
John McHenry, owner, F/V Seymour, Alaska, Aleutian Islands

The animals have learned to target individual boats, and are leading fishers on high-speed chases to get away : AP Photo/Elaine Thompson)

Are animals intelligent? Can they assess situations and react to them to further their own interests? Ask the fishermen who have been experiencing some unusual episodes of new behaviour expressed by aggressive orcas, forming pods skilled in harassing boats and harvesting their fish. "Since 1997, reports of depredation have increased dramatically", a report by the Southeast Alaska Sperm Whale Avoidance Project has noted.

It has by now been well enough witnessed and documents that orcas can patiently wait for fishermen to acquire a halibut cache, even if it takes all day, to then move in to strip the fishing lines. Cod and halibut fishers off the coast of Alaska have traditionally experienced peaceful coexistence with the orcas in the region. That was then; now the orcas have turned on the fishers to strip them of their catches.

Sperm whales, large and square-headed, have been pillaging fishing lines as well. A video taken in 2006 by the Avoidance Project succeeded in filming one of the 50,000-kg whales as it delicately shook loose fish from a fishing line. "I've had the same sperm whale follow me 70 miles", complained Michael Offerman of the F/V Kristiana.

The Bering Strait separating western Alaska from Russia appears to be the locus where the worst incidents of whale hijacking of fishers has been taking place, though fishing boats across Alaska have been reporting orca harassment. The cost of fish loss from orcas appropriating the fish from lines was estimated at $500 daily, according to a 2014 study.

While a 2015 study of fishing boats in Uruguay where similar fishing techniques are used discovered "the presence of killer whales in the fishing ground seems not to affect the catch per unit effort."  A rebound of North Pacific whale populations resulting from the 1980s moratorium on commercial whaling appears to be linked to the increasing predation of whales on fishing boat catches.

Up to the rebound, cod and halibut fishers' experience had been that of moving among populations of whales surviving the hunt by whaling fleets, where survivors had learned that the approach of a boat engine spelled danger to them. Earlier, in the 1990s, researchers had discovered that a sudden collapse in Pacific sea otter populations was caused by orca predation.

The orca social structure is a complex one; just like humans they have regionally distinct languages and strategies for hunting. Orcas have often been observed to be strategizing new hunting tactics, and teaching those advantageous new techniques to other whales. Alaska fishers claim to be seeing an increasing number of juveniles taught by their elders to snatch fish from fishing vessels.

Inuit have also observed that orcas swimming deeper into the Arctic as a result of polar ice cover melting, have been preying on slower-moving local fauna. Orcas, stated an Inuit interviewed for a 2012 study, would sometimes kill "hundreds" of belugas at one time. "When the killer whales had left the kill site, Inuit would collect the maqtaq (blubber) from the numerous dead belugas."

Making their home in all seven of the world's oceans, orca pods have been witnessed killing other top marine predators, including great white sharks, walruses and leopard seals.

File -- National Post

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Thursday, June 22, 2017

The Perspective of Moderation

"Lectins are plant proteins that protect the plant and its seeds from being eaten by basically hacking into the animal's immune system, causing the animal to have inflammation."
"The most troublesome plant lectins are found in the hulls of grains, in beans and legumes, and the nightshade family -- specifically the peels and seeds of tomatoes, peppers, eggplants, etc."
"Although I am a voracious plant predator, one has to realize that there is not a human need for fruits and vegetables; just ask an Eskimo."
Dr. Steven Gundry, cardiovascular surgeon, medical researcher, writer, U.S.


This is a medical researcher who believes that lectins, which are the proteins located in some species of plants which nature devised for their protection from predators, could represent the root cause of a number of diseases. Lectins, according to Dr. Gundry, have the potential of causing inflammatory effects on the human body, stimulating gut-related health outcomes such as leaky gut, autoimmune disorder and weight gain.

The condition of inflammation is a warning sign that things are not right. And inflammation is involved in many of the body's health issues, some of which will pass, and others which will help cause far more serious injury to the body.
  • Inflammation is the body's attempt at self-protection to remove harmful stimuli and begin the healing process.
  • Inflammation is part of the body's immune response.
  • The first stage of inflammation is often called irritation, which then becomes inflammation - the immediate healing process.
  • Inflammation is followed by suppuration (discharging of pus). Then there is the granulation stage, the formation in wounds of tiny, rounded masses of tissue during healing.
  • Acute inflammation - starts rapidly (rapid onset) and quickly becomes severe.
  • Chronic inflammation - this means long-term inflammation, which can last for several months and even years.
  • Our infections, wounds and any damage to tissue would never heal without inflammation - tissue would become more and more damaged and the body, or any organism, would eventually perish.
  • Chronic inflammation can eventually cause several diseases and conditions, including some cancers, rheumatoid arthritis, atherosclerosis, periodontitis, and hay fever.
  • Although scientists know that inflammation plays a key role in heart disease and several other illnesses, what drives inflammation in the first place is still a mystery.
  • It should be remembered that inflammation is part of the healing process. Sometimes reducing inflammation is necessary, but not always. MNT home

Studies, including one report published in the BMJ Medical Journal, have indicated that the consumption of an excess of lectins is capable of damaging the intestinal lining to trigger chronic inflammation. Chronic inflammation can be responsible for the onset of asthma, Crohn's disease and arthritis, as pointed out in a scientific paper published in Live Science. In other words, eating some species or genus of fresh, unadulterated fruits and vegetables may now come with a caution.

On the positive side, Dr. Gundry also points out that some plant foods that fit his potentially dangerous labelling contain as well health-enhancing befits such as polyphenols which have the capacity to improve the immune system, as well as the brain, nerve and blood vessel functions. But does that balance out the caution being issued on avoiding lectin-containing vegetables and fruits?

Yet another headache for those people who are ultra conscious of avoiding gluten and genetically modified grains and food products, along with saturated fat (whose reputation has recently been given a reprieve), excess salt and the avoidance of sugar, fructose, glucose, etc. But wait: nutritional advice that goes heavy on the recommendation of weighing one's diet heavily in favour of fresh fruits and vegetables on a daily basis needn't be thrown into the waste-bin.

Remember that old adage of moderation being the key to solve most problems? Even the ancients knew all about moderation, they called it the Golden Mean, and for good reason. Dr. Gundry's book The Plant Paradox, may focus on the potential for ill in certain fresh vegetables on the human alimentary system, but take a close look at what he says; they may cause problems. And they may not.

It's somewhat similar to scientists isolating a certain ingredient or chemical or mineral that they believe to be cancer-causing, because in laboratory mice they have proven to be so. And then one discovers that in the experiment, the test animals were exposed to the carcinogenic item in massive amounts, amounts so great that in the natural world that massive intake would simply never occur.

In the case of lectins suspected to be a source of inflammation onset, it's not a little that goes a long way; it's a lot that may cause the problem. How likely is it that anyone will pig out on eggplant for example, eating it in great amounts on a continuous basis? Consuming reasonable amounts of fresh fruits and vegetables with a focus on variety and quality not quantity and not favouring a very narrow type, ensures we get the vital vitamins and minerals and roughage required in our diet.

So go ahead, eat a colourful and fresh variety of fruits and vegetables daily, and be reasonable about amounts you consume.

Inflammation helps wounds heal

Our immediate reaction to a swelling is to try to bring it down. Bearing in mind that inflammation is an essential part of the body's attempt to heal itself, patients and doctors need to be sure that the treatments to reduce swelling are absolutely necessary and to not undermine or slow down the healing process.
Wrist inflammation
The first stage of inflammation is often called irritation, which then becomes inflammation - the immediate healing process. Inflammation is followed by suppuration (discharging of pus). Then there is the granulation stage, the formation in wounds of tiny, rounded masses of tissue during healing. Inflammation is part of a complex biological response to harmful stimuli. Without inflammation, infections and wounds would never heal.  MNT home

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Wednesday, June 21, 2017

Sex Roulette

"Oftentimes, people don't realize they have a gap in their knowledge. People don't know what they don't know."
"I don't think we can call that [2006 survey questioning Canadian women where 64 percent reported an unintended pregnancy, with 61 percent reporting in 2017] much of [a] change."
Dr. Jennifer Blake, chief executive, Society of Obstetricians and Gynaecologists of Canada

"A person who is using withdrawal as a contraceptive method is someone who has not planned for contraception, period. They haven't thought about the need to practice contraception. A significant proportion of Canadian women are essentially making a spontaneous decision in the absence of any planning for sexual activity."
"It's fair to say a wide swath of the sexually active adult population in Canada is not taking care of their sexual and reproductive health."
"We sometimes make the assumption that as teenagers grow into young adults and then into full adulthood, they become naturally more responsible. But we know condom use declines with age. I don't see anything that shows people get better at protecting sexual and reproductive health as they get older."
Alex MacKay, executive director, Sex Information and Education Council of Canada
Condoms are one of the favoured forms of contraception, according to a survey of more than 3,200 Canadian women. WPpost image

A recent survey undertaken by the Society of Obstetricians and Gynaecologists of Canada revealed some interesting, somewhat surprising and most certainly disappointing realities. One of the survey's major findings was that women no longer seek contraceptive information from doctors; instead they look online for their options, even though many of the women responding to the survey stated that they don't necessarily trust online information.

The fact that women, who at one time saw their doctors on a yearly basis for an annual Pap smear, and that routine has been placed on a back burner, with women seeking out their family doctor less frequently may explain in part the situation. What was also revealed was that one in four women has no idea how to proceed when they miss taking a birth control pill, or other hormonal contraception.

IN response to this situation the SOGC is preparing to release a new online source they have named S.O.S., meant to guide women through that scenario and what their response should be. The website SexandU.ca has also been relaunched, with plans to publicize a media campaign later in the year. An online program will expose women to the best forms of contraception from among an array of options, based on age and circumstances.

What the results of the survey revealed that turned out to be the most surprising element relating to contraceptive methods was the identification of one of the most favoured contraception methods; withdrawal. Women in the survey placed withdrawal in third place, following birth control pills and condoms, out of a menu of various contraceptive options.

While Dr. Blake doesn't mind acknowledging that withdrawal can be recognized as a type of contraception, she emphasizes that this cannot be considered a sound pregnancy prevention method, in particular for younger people. Let alone the concerns surrounding the contact and spread of sexually-transmitted infections.

That, added to the fact that most women appeared unaware of many of the contraceptive options that currently exist, surprised the researchers. That many women knew nothing of intrauterine devices (IUDs) as representative of one of the most effective contraceptives available, points to a severe lack of responsibility on the part of women of child-bearing age who are sexually active. A mere 3.7 percent of women in the survey reported having used a copper IUD, while 7.1 percent only had used an intrauterine system or hormonal IUD.

The survey results appear to confirm previous research findings that birth control pills and condoms overwhelmingly represent the most popular forms of birth control. Yet the frequency with which women cite withdrawal as a contraceptive method has the researchers concerned. Withdrawal was used by close to 29 percent of women between the ages of 15 and 19 who responded to the SOGC survey.

In comparison, 45 percent of women between 20 and 29 and 42.7 percent of women between 30 and 50 also made contraceptive use of withdrawal; age demographics that the medical profession might imagine would know better. Concern was also raised over the fact that greater numbers of young women between the ages of 20 to 29 used withdrawal than did teens.

That old adage that "We get too soon old and too late smart" appears to have undergone a strangely unaccountable reversal.

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Tuesday, June 20, 2017

Pregnancy and Marijuana Don't Gel

"Our worry is that because it is made legal [marijuana], people may think it is not a problem."
"While it will be legal [in Canada by July 2018], the SOGC's position is that we believe there are adverse effects on brain development from marijuana consumption until the brain development is finished, which is not until the early 20s. It is legal, but should be strongly discouraged."
"There are safe and more effective medications for nausea in pregnancy. My hope is that it is not used because of the adverse effects on brain development."
"This rise [of marijuana use in pregnancy] is purported to be a combination of the frequency of prescribed opioids for pain control in pregnant women, illicit use, and an increase in opioid-substitution programs for treatment of addiction -- opioids are now being used by a more diverse population that includes pregnant women."
Dr. George Carson, president, Society of Obstetricians and Gynecologists, Canada

"We really want to look at what women are doing now related to substance use -- what is happening during pregnancy, what do women believe, what are their behaviours and where do they get their information."
"We know that 15 percent of women drink alcohol during pregnancy, we don't have the same information around cannabis use -- we are scrambling to try to figure out how we can help target those populations."
Dr. Jocelynn Cook, chief scientific officer, SOGC
Marijuana Use During Pregnancy and Lactation
ABSTRACT: Cannabis sativa (marijuana) is the illicit drug most commonly used during pregnancy. The self-reported prevalence of marijuana use during pregnancy ranges from 2% to 5% in most studies. A growing number of states are legalizing marijuana for medicinal or recreational purposes, and its use by pregnant women could increase even further as a result. Because of concerns regarding impaired neurodevelopment, as well as maternal and fetal exposure to the adverse effects of smoking, women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use. Obstetrician–gynecologists should be discouraged from prescribing or suggesting the use of marijuana for medicinal purposes during preconception, pregnancy, and lactation. Pregnant women or women contemplating pregnancy should be encouraged to discontinue use of marijuana for medicinal purposes in favor of an alternative therapy for which there are better pregnancy-specific safety data. There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.  Committee Opinion

The medical proscription against the use of alcohol during pregnancy is very well known throughout society. The fact that children are born with withdrawal symptoms in fetal alcohol syndrome is a blight on society. These are children whose full mental faculties have been impaired, whose development along the milestones of maturity will never catch up to their peers whose mothers did not indulge in alcohol and drugs during pregnancy.

Yet despite all that is known and that these behaviours during pregnancy bring into the world children whose full potential will never be realized, it seems that an almost casual use of marijuana among women during pregnancy is taking place. At a time when caution and care is required to ensure that the developing fetus has all the advantages that genetic inheritance can bestow upon a new life, a kind of low-grade epidemic of marijuana use meant to counter the early nausea stages of pregnancy appears to have become routine.

And it is this identified behaviour that has physicians concerned for the future of these children. Medical marijuana is already legal in Canada. In a year's time marijuana will be freely available for consumption when a new law is passed and regulation guidelines are in place, but even so there are concerns over the potential for the kind of abuse that law enforcement and society grapples with in the instance of driving while impaired by alcohol, soon to be joined by pot-impaired driving offences.

That marijuana is being promoted among some within society as an effective anti-nauseant during early pregnancy has become a growing problem in Canada. Concerning for a number of reasons, not least among them that a growing body of evidence isolates negative effects on brain development resulting from marijuana exposure; the executive functions of the brain affected, along with behaviours.

Dr. Jocelynn Cook of the Society of Obstetricians and Gynecologists of Canada points out that the second leading killer of women during pregnancy is substance use linked to the ubiquitous presence of fentanyl. The steadily emerging trend of opioids among women in pregnancy is concerning to the medical community. As it is, Canada is known to have some of the highest rates of cannabis use among developed nations by adolescents, and along with it, a rapid rise in opioid use.

Resulting in an increasing number of babies born addicted to opioids. Dr. Carson feels that convincing a pregnant woman addicted to opioids to seek medical treatment through a methadone program can still help to improve both her health and that of her baby. Cannabis remains the most used illicit substance during pregnancy, with estimates ranging from under two percent to over 15 percent in prevalence.

The report recently issued by the Society of Obstetricians and Gynecologists of Canada points out that its widespread use "may be due in part to its reputation as a harmless drug", while during pregnancy no drug is harmless.

Fast Facts

  • Using marijuana during pregnancy may increase your baby’s risk of developmental problems.
  • About one in 25 women in the U.S. reports using marijuana while pregnant.
  • The chemicals in any form of marijuana may be bad for your baby – this includes edible marijuana products (such as cookies, brownies, or candies).9
  • If you’re using marijuana and are pregnant or are planning to become pregnant, talk to your doctor.     Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People

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Monday, June 19, 2017

Ultra-Commercializing Motherhood -- Darwin Spinning in his Grave

"We hope to begin cases [in Canada] within the next few weeks.This technique is a new platform. How far it  can go, I really cannot imagine."
"When the world's first heart transplant occurred in South Africa, the community was afraid the doctor had transferred the soul of one person into another."
"[The first babies born from IVF (in vitro fertilization) in 1978 were considered] an unnatural abomination."
"We have the world's first successful [three parent] birth. Of course there is need for long-term study of that baby, and other cases. [However], we had twenty years of research before moving to the first case study."
Dr. John Zhang, New Hope Fertility Clinic, Manhattan
Dr John Zhang with the world’s first baby born using DNA from three people. The baby is reported to be healthy
Dr John Zhang with the world’s first baby born using DNA from three people. The baby is reported to be healthy. Photograph: New Hope Fertility Center

"This is unethical, irresponsible and exploitative."
"The chance of failure with IVF for women over the age of 45 is 98 percent. At best (and this is unlikely), this experimental intervention might reduce the chance of failure to 70 percent."
"This is about selling false hope."
Dr. Francoise Baylis, bioethicist, Dalhousie University

"We know that we're very close [medical science] to being able to make a gamete out of any type of body cell."
"Right now we make gametes naturally -- men make sperm, women make eggs. We put them together, magic happens, and you have a baby."
"Here we're starting to understand reproduction at a cellular level. The next step is to say, well, if I can do this in an egg cell, why can't I make an egg cell? Why can't I make a sperm cell? Why do you have to be female to make an egg?"
"There are big-picture questions, and what Zhang's done is give us another step on the ladder to attacking those big-picture questions."
"We fixed this person's infertility -- we change their microcellular structure, and that child goes off and reproduces. What is it they pass on? And what is it their children pass on?"
"It's accelerating our evolutionary process in a completely unprecedented way."
Dr. Roger Pierson, infertility expert, University of Saskatchewan
Mitochondrial diseases can be passed from mothers to their children in DNA.
JGI/Tom Grill/Getty Images

The technique is described as a spindle nuclear transfer. The first baby conceived through this new technique was born last September. The baby's mother had lost two other children; she was a carrier of a progressive neurological disorder led by a mutation in her mitochondrial DNA; a lethal-to-survival condition for a newborn. Dr. Zhang performed a mitochondrial replacement using the mother's egg in a laboratory in the United States. The embryo transfer took place in Mexico to evade U.S. laws where the procedure is banned.

The process proceeds with the removal of the nucleus of the mother's egg containing the maternal DNA, then injecting it into the egg of a young donor. The donor egg which has been stripped of its own nucleus possesses a younger mitochondria. And since this is the mechanism whereby energy is provided to every living body cell, the mitochondria of older women have a decreased energy-output, less able to fuel cell division post-fertilization to achieve pregnancy.

The new egg, 'reconstituted' is then ready to be fertilized with the sperm of the male partner at which time the embryo that results is transferred to the older mother's womb. And in the best-case scenario, which is what the procedure aims for, in due time a healthy baby results. Dr. Zhang's creative new methodology exchanges nuclear contents to turn the donor egg into a 98.9 percent genetic match to the mother, leaving a less-than-significant DNA contribution of 1.1 from the donor.

Doctors carrying out treatment
The mitochondrial transfer technique is aimed at those with a high risk of passing on debilitating diseases. Photograph: Ben Birchall/PA

This startling new direction in altering a would-be mother's egg to expunge the reality of a devastating mitochondrial disease being transmitted to children while still retaining the gross bulk of the mother's DNA to distinguish her children as her very own is understandably viewed with suspicion if not downright alarm by many in the medical community. Yet another addition to the already-lucrative fertility industry, Dr. Zhang's method boasts a capacity to "reverse the effect of age" on human eggs.

Among those viewing this technique with alarm are those who speak of the hubris in medical science out-running nature's formula for reproduction resulting in fears of deliberately designed genetic enhancement; "designer babies", with the technology utilized to 'edit' eggs and sperm of their less-favoured traits and substitute them with more elegant versions. Apart from which the long-range effects of how these genetic manipulations will eventually play out in the future through following generations represents a worrisome potential into the unknown.

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