- The Journal of the American Medical Association (JAMA) has just reported an interesting shift in end-of-life interventions offered to patients in European Intensive Care units over the past 17 years: withholding life-prolonging therapy and withdrawing of life-prolonging therapy increased by 10% and 14% respectively. The proportion of women patients was roughly the same (about half) over the whole period, but the patients in the 2015-2016 group were 3 years older on average (a significant difference) compared to previous years.
- Reproductive technology for same-sex parents may soon be a reality; although 74%of American adults are parents, only 35% of the LGBT community are parents, although 51% of them would like to have children. While in vitro fertilization and surrogacy offer partial genetic relatedness, new techniques may make specially prepared stem cell-generated pregnancies possible for generating embryos of two mothers or two fathers possible. So far, success has been limited in mice, but techniques are improving and human embryos may be prepared successfully from homosexual couples.
- Two Chinese groups report successfully maintaining monkey embryos for 20 days in a dish, besting the US report of 13 day survival of human embryos. The US terminated the experiment after this time because the international community has banned maintaining human growth for more than two weeks; monkeys, our close relatives, are therefore very useful for an improved understanding of early human development. Importantly, the type and characteristics of the cells of these embryos were virtually identical to normal embryonic development.
- The problem of drug resistant bacteria is significant: the CDC reports that almost 3 million infections and 35,000 deaths a year are caused by the “deadly superbugs”. The Washington Post reports that on average, an American gets an antibiotic-resistant infection every 11 seconds and every 15 minutes, someone dies.18 antibiotic resistant bugs take on humans and of these, 5 are the most frequent, including the dreaded c. dificile, (the cause of drug resistant gonorrhea), and the carbapenem-resistant Enterobacteriaceae (CRE) which are resistant to all or nearly all antibiotics and which kill half of patients infected with them.
- The New York Times has just reported another terrifying intervention by the Trump administration into the activities of the Environmental Protection Agency: a new proposal to require scientists to disclose all of their raw data including confidential medical records in preparing their reports. This proposes a real problem to documenting threats to health, because many studies detailing links between pollution and disease rely on personal health information gathered under confidentiality agreements. The results could significantly change our ability to report the levels of hazardous smog in the area, lead in patient and mercury in water, among other pollutants.
- A fascinating new idea being worked on by teams at MIT and the Virginia Commonwealth University will drastically change the way we obtain the drugs we use to treat patients; Nature magazine reports a briefcase furnished with all the ingredients of commonly used medications that can be made by the user: one inventor’s do it yourself drug kit is called Bio-MOD; several versions of the idea have been backed by the US military.
- Spectacular advances in visualizing smaller and smaller objects include the work of Titia de Lange, Leon Hess Professor at the Rockefeller University; she has invented something called Stochastic Optical Reconstruction Microscopy (STORM) to capture images at the level of the genome in single cells. She is illuminating communications between nerve cells and creating three dimensional images of our genome. This amazing new technique will help accelerate our understanding of how gene expression is regulated and inevitably create new powers for improving the human phenotype.
Dr. Marianne Legato, Professor Emerita of Clinical Medicine at Columbia University is an internationally known academic physician, author, lecturer, and specialist in gender-specific medicine. She is founding member of the International Society for Gender Medicine and also the founder and director of The Partnership for Gender-Specific Medicine at Columbia University and its next iteration, The Foundation for Gender-Specific Medicine. These enterprises are the first collaborations between academic medicine and the private sector focused solely on gender-specific medicine: the science of how normal human biology differs between men and women and of how the diagnosis and treatment of disease differs as a function of gender and sex. Her ground breaking textbook on Gender-and Sex Specific Medicine has been published in 2017 in the 3rd edition.
She has published extensively on Gender and Sex Specific Medicine, both scientifically and for the lay public. She is also the founding editor of the journal Gender Medicine, and the Journal Gender and Genome, published for the scientific community. In 1992, Dr. Legato won the American Heart Association’s Blakeslee Award for the best book written for the lay public on cardiovascular disease. She is a practicing internist in New York City and has been listed each year in New York Magazine’s “Best Doctors” since the feature’s inception in 1993.