Monthly Archives: March 2010

Baby Isaiah’s parents expect second child

There is some happy news for the parents of Isaiah May, who died earlier this month after being removed from life support. Isaiah’s mother, Rebecka, reports that she is now pregnant with her second child.

Baby Isaiah was born after 40 hours of labor with his umbilical cord wrapped around his neck, depriving his brain of oxygen. He was unable to breathe without a ventilator, and doctors determined that he was severely brain damaged. Born on October 24, 2009, his parents’ legal battle to keep him on life support received considerable publicity, especially in Canada. In the end, his parents agreed to remove their child from life support before being forced to do so by a legal court order.

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Gonorrhea bacteria: The next superbug?

Bad Bugs No Drugs

After chlamydia, gonorrhea – also known as the “clap” — is the second most common bacterial STD (sexually transmitted disease). It’s easily transmitted. Women have a 60-80 % chance of becoming infected after a single sexual encounter with an infected male partner. Left untreated, the disease not only causes unpleasant symptoms – painful urination, urethral and vaginal discharge, projectile urination – but can lead to sterility.

Superbugs are bacteria that have become resistant to multiple antibiotics. The organism that causes gonorrhea (Neisseria gonorrhoeae) is very versatile and quick to develop resistance.

A few decades ago, gonorrhea became resistant to penicillin. Tetracycline is no longer effective. The disease is rapidly becoming resistant to the fluoroquinolone family of broad-spectrum antibiotics (ciprofloxacin, ofloxacin, levofloxacin). Currently, doctors use cefixime or ceftriaxone to treat gonorrhea, but there are now signs of resistance to these drugs as well, particularly to cefixime.

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"Dad, the 'unfinished business' is done."

Ted Kennedy’s youngest son, Rep. Patrick J. Kennedy, visited his father’s grave on the day after health care reform was passed. He left a hand-written note, written on one of his congressional note cards: “Dad, the ‘unfinished business’ is done.”
Senator Kennedy, in a letter delivered to President Obama by Vicki Kennedy after her husband’s death, had written: “You will be the president who at long last signs into law the health care reform that is the great unfinished business of our society.”
Kennedy is buried in Arlington National Cemetery. There were hundreds of visitors to his grave site this week, including family members and colleagues. David Bowen, who had been Kennedy’s health director, had vowed at the senator’s funeral that he would not visit the grave until health care reform was passed.

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The Supreme Court and health care repeal politics

Repeal health care reform

Source: The Economist

Attorneys general from 14 states (so far) are filing lawsuits to challenge the constitutionality of health care reform. Some have the support of their Republican governors. Others have incensed their Democratic governors. Orin Kerr, on the conservative/libertarian law professors’ blog The Volokh Conspiracy, gives the odds of repealing the individual mandate as less than 1%. He believes the matter will be dismissed in the lower courts and never reach the Supreme Court.
Linda Greenhouse, a longtime observer of the Supreme Court, makes her own case for why the repeal efforts will be futile and a waste of taxpayers’ money. Her argument is not based on the principle of federalism or the Constitution’s “commerce cause,” but on the personality and character of the Supreme Court justices.

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Global challenge: 10 new antibiotics by 2020

Bad Bugs No Drugs

The Infectious Diseases Society of America (IDSA) has issued a statement challenging global leaders to develop 10 new antimicrobial drugs by 2020.

The time has come for a global commitment to develop new antibacterial drugs. Current data document the impending disaster due to the confluence of decreasing investment in antibacterial drug research and development concomitant with the documented rapid increase in the level of resistance to currently licensed drugs. Despite the good faith efforts of many individuals, professional societies, and governmental agencies, the looming crisis has only worsened over the past decade. …

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Health care: A history of last minute arm twisting

The media love to play the upcoming health care vote as a sporting event, with daily play-by-play analyses of whether Nancy Pelosi will get the 216 votes she needs to pass the reform legislation. Speculations on the vote count are meaningless, however, until the very last minute. Those members of Congress whose votes mean success or failure are highly motivated to keep their decision secret. There’s a history in Congress of holding out, in hopes of being courted with offers favorable to a congressional district and re-election.
Karen Tumulty writes: “Keep in mind that it is not in the interest of the lawmakers who hold the key votes to show any flexibility at this point. The real movement comes at the very last minute. … [U]ntil a vote has been scheduled, and we are within 48 hours of seeing it happen, take anything you hear from anyone on Capitol Hill with a full box of salt.”

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Actions surrounding the moment of death are highly symbolic

losing-a-childIn a recent article in The New England Journal of Medicine entitled “Is It Always Wrong to Perform Futile CPR?”, a doctor describes the case of a baby boy who had been born with a large encephalocele on his forehead – a neural tube defect that allows the brain and its surrounding membrane to protrude outside the skull. The child survived surgery to remove the growth, but was left effectively brain dead (“neurologically devastated”).

The doctor, Robert Truog, a professor of medical ethics, anesthesia and pediatrics at Harvard Medical School, had cared for the boy when he was repeatedly admitted to the intensive care unit. The parents had been advised to limit the boy’s care to the relief of pain, but they insisted that doctors treat the child aggressively and do everything they could to keep him alive. The boy had survived the first two years of his life.

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Baby Isaiah May, October 24, 2009 – March 11, 2010

Baby Isaiah May was allowed to die today, in the arms of his parents. The child was surrounded by 10 family members, including a grandmother who had traveled from Washington State.
Today was the date set for the next court appearance in the May’s attempt to keep their child alive. In statements after last month’s legal proceedings, the parents suggested they might be planning to make this decision on their own, rather than leave it up to the courts. And that’s what happened today. The court appearance was canceled.

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