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WHO Recommends Worldwide Use Of Rotavirus Vaccine For Children
To reduce an estimated half million deaths and two million hospitalizations from diarrhea caused by rotavirus each year, the WHO on Friday recommended that oral rotavirus vaccines be added to national childhood immunization programs, broadening access to the vaccine in the developing world,

Broken Bones Heal Faster With Drugs
Bone fractures might heal faster if the patient is injected with medications. This is the outcome of a unique study of 102 women with wrist fractures.
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CDC Prioritizes H1N1 Vaccinations For Pregnant Women
When the H1N1 flu vaccine becomes available in the fall, pregnant women should be among the first groups vaccinated because of their high risk for serious complications, a Centers for Disease Control and Prevention expert panel said on Wednesday, the Washington Post reports. The 15-member committee advises CDC on vaccine policy. The priority list also includes caretakers of infants, health care workers, children and young adults, and older people with chronic conditions. Anthony Fiore, a physician and epidemiologist at CDC, told the committee that about 6% of H1N1 deaths and hospitalizations are among pregnant women (Brown, Washington Post, 7/30). According to a CDC study published online Wednesday in the journal Lancet, pregnant women who contract the H1N1 virus -- also known as "swine flu" -- are at least four times more likely to be hospitalized than other people with the virus, the AP/Google reports. The study analyzed the first 34 U.S. cases, including six deaths, in pregnant women from April to mid-June of 2009. Although it is not clear if pregnant women are more susceptible to the virus, they have a higher risk of complications after becoming infected. The study"s authors said pregnant women suspected of having H1N1 should be administered Tamiflu as soon as possible, prior to the completion of diagnostic testing. CDC"s Denise Jamieson, the lead author of the study, said that Tamiflu appears relatively safe for pregnant women, despite limited safety data on its use in that population.Most pregnant women who contract H1N1 have mild flu symptoms like a cough or fever, according to the World Health Organization. Jamieson said that CDC does not recommend specific precautions for pregnant women but that doctors should act quickly -- preferably within 48 hours -- if a pregnant woman shows symptoms. She added that the pregnant women who died were basically healthy, and nearly all had viral pneumonia before experiencing acute respiratory problems prior to their death (Cheng, AP/Google, 7/29).CDC"s priority groups include about 159 million people out of a total U.S. population of more than 300 million, the Chicago Tribune reports. The agency expects to have about 120 million doses of the vaccine by the end of October. Officials are confident there will be enough for their target groups because only 20% to 50% of those recommended to receive seasonal flu vaccines seek them out. However, if supplies of the vaccine are unexpectedly restricted, the panel recommended that a smaller group -- about 41 million of the most susceptible to adverse side effects from infection or most likely to spread the virus -- be given priority for the vaccine. This smaller group also includes pregnant women (Maugh, Chicago Tribune, 7/30).
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Call For Public Debates On Future Uses Of Stem Cells Lead By Bioethicists

More than 40 scientists, bioethicists, lawyers and science journal editors are calling on their colleagues, policy makers and the public to begin developing guidelines for the research and reproductive use of stem cell-derived eggs and sperm, even though such use may be a decade or more away. "Science has always moved faster than social debate or society"s ability to grapple with these issues," says Debra Mathews, Ph.D., lead author of a paper published in the July issue of Cell Stem Cell and assistant director of science programs at the Johns Hopkins Berman Institute of Bioethics. The paper calls for all parties to begin engaging in open discussion and debates, and describes the need for informed social policy well in advance of the eventual use of eggs and sperm derived from pluripotent stem cells. Mathews said stem cell researchers need to be better prepared to address public questions about uses of so-called pluripotent stem cell-derived gametes -- regardless of how realistic or soon those uses may be. Such uses would potentially include reproductive uses such as the creation of sperm and eggs for in vitro fertilization, embryo selection based on genetic profile, and the creation of embryos from the tissues of fetuses, children and the deceased. The issues are too complex, and the stakes are too high, the authors suggest, for the public to be caught unaware by some new capability for using stem cell-derived gametes, and the research already is moving rapidly toward generation of sperm and eggs capable of making human embryos and potentially children. "Because derived-gamete research will require the creation and destruction of human embryos, this line of research will be morally objectionable to those who imbue human embryos with full moral status, and those objections must be addressed," the authors state. In their paper, the Johns Hopkins-led team described an analysis of the current state of pluripotent stem cell science and suggested a framework for the debates that need to take place. There was consensus by the authors that policymakers should not restrict scientific inquiry solely because ethical or moral disagreement exists about the use of these cells. Instead, they offered recommendations for guidelines that would be the focus of social debate. Among them were that restrictions should be specific to those aspects of the technology that are deemed morally unacceptable in a given nation or state, and that specific consent should be required of tissue donors whose cells will be used to derive gametes for use in reproduction. This approach would rule out using for reproduction any tissue from fetuses, minors and the deceased. Consent, they said, need not be required in situations involving laboratory studies that produce no embryos. The authors emphasized that significant oversight rules must be in place before any reproductive uses of gametes even begins, and early attempts to use gametes for these purposes should take place only as part of clinical research that follows the highest ethical standards. Assuming that reproductive use of stem cell-derived gametes does occur, the health of women carrying the resulting fetuses, and of children born to them, should be monitored rigorously and tracked in long-term studies. Pluripotent stem cell-derived gamete research brings together several of today"s most contentious ethical issues, including the use of embryonic stem cells, the increasing ability to identify and understand risks associated with particular parts of the human genome, advanced reproductive technologies to treat infertility and interest in "human enhancement." Mathews noted that pluripotent stem cell-derived gamete research already is producing significant advances in basic understanding of how eggs and sperm develop from germ cells, infertility, genetic diseases and some cancers. Mathews said the most difficult scientific issue the study team faced was predicting how long it would take to get from a human stem cell to a set of gametes capable of successful test-tube fertilization, and how long, if ever, it would be until such gametes are used in clinical care. The group believes it will take at least a decade to develop derived human gametes and that clinical applications likely won"t be available for several years beyond that. Whatever the time frame, she said determining whether pluripotent stem cell-derived gametes can function reliably and normally is critical for both nonreproductive and reproductive purposes. Scientists and the public also must prepare, Mathews noted, for the potential production of large numbers of human gametes that facilitate multigenerational laboratory studies of human genetics and disease. "Although many welcome the prospects for disease prevention and health promotion that such research should facilitate, many others will find the treatment of human embryos in such blatantly manipulative ways to be ethically unacceptable," the authors said in their paper. Other authors of the paper are Peter J. Donovan of the University of California, Irvine; John Harris of the University of Manchester; Robin Lovell-Badge of the MRC National Institute for Medical Research; Julian Savulescu of the University of Oxford; and Ruth Faden, director of the Johns Hopkins Berman Institute of Bioethics in Baltimore. Christen Brownlee Johns Hopkins Medical Institutions


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