Issues in Law & Medicine最新文献

Objective: South Asia, a historically low-incidence region for breast cancer, has produced many recent studies examining reproductive factors. We compiled these studies to confirm the reality of the significant association reported in the first, 1996 review of induced abortion as a risk factor, independent of abortion's known effect in abrogating the protection afforded by full-term pregnancy.

Methods: We searched the medical literature for English language studies on breast cancer incidence in women in South Asia published from 1 January, 2000 through 30 June, 2017, using Pubmed, Scholar-Google, and bibliographic searches. Studies were included which reported overall data on induced abortion and/or abortion non-specifically. All 20 eligible studies were of retrospective, case-control design. Data from individual studies were combined using random effects modeling, following the determination of significant heterogeneity.

Results: Cumulative OR for all 20 studies was 2.51 (95%CI: 1.67-3.75) and 3.91 (95%CI: 1.02-14.97) for the five studies which reported specific data on induced abortion. Significant dose-dependence was observed among all 5 studies which stratified by number of abortions. Meta-regression of OR v. abortion prevalence among controls was statistically significant, as observed in a 2013 meta-analysis in China.

Conclusion: The moderately strong association identified between abortion and breast cancer explains in part the spread of the breast cancer epidemic to South Asia as it has become Westernized. Continuing denial of the abortion-breast cancer association can only ensure that the acknowledged worldwide breast cancer epidemic will continue to worsen, costing many millions of women their lives over the next several decades.

Studies from many nations suggest that induced abortion (IA) may be a causal risk factor for the development of breast cancer. Researchers agree that IA contributes to the increased risk of breast cancer by delaying the timing of a full-term pregnancy which is a protective factor. Increasing numbers of studies now show that IA prior to 32 weeks in and of itself is a risk factor for breast cancer due to the physiology of breast development and the manner in which abortion interferes with the maturation of the breast cells. Although largely ignored by the mainstream medical community, this risk information deserves a prominent place in the education of all adolescent women who may, in the future, consider an IA.

Background: Down syndrome (trisomy 21) is a well-known cause of mental retardation. It can be diagnosed in early pregnancy. Scientists have made great strides in outlining the pathophysiologic mechanisms of mental retardation in Down syndrome. Much less has been published on human therapy. To our knowledge, these are the first published cases of fetal therapy for Down syndrome.

Methodology: Reports of three cases. In all cases, treatment was both biochemical (e.g. nutritional) and educational. In all cases, treatment was both before and after birth.

Results: All children lacked the characteristic faces usually seen in the children with Down syndrome. This suggests a treatment effect before birth. All children had better than expected development.

Discussion: Enhancement of development is proposed as a new therapeutic principle. Developing neurons exchange neurotrophic factors during development when they give or receive stimulation from other neurons. Neurons which receive neurotrophic stimulation survive, and those, which do not, are lost to apoptosis. The developmental therapeutic principle seeks to optimize brain development. Biochemical inputs (neurotransmitters, drugs, hormones, nutrients) and functional stimulation are integrated to optimize the growth and survival of neurons individually; other cells; subcellular organelles; and the brain as a whole. Treatment may be before and after birth, both biochemical and functional. These principles may be applied to Down syndrome, other conditions, and normal fetuses or children.

Previously published: Baggot PJ and Baggot RM (2014). Fetal Therapy for Down Syndrome: Report of three cases and review of the literature. J Am Phys Surg 19(1):20-24.