Volume 3 Issue 5 – April 2007
Structural Variation in the Human Genome – An NEJM Clinical Implications of Basic Research Article
R Lupski, NEJM, March 15 2007, Vol 356 (11)
Recently, biologists have found that individuals actually have many large-scale rearrangements in their genomes, such as deletions, inversions, or duplications that can affect gene fragments or even entire genes, and not just single point mutations. This “structural variation” affects the regulation of many different genes, and Dr. James Lupski explores the clinical implications of these large rearrangements.
Ethical Challenges Posed by the Solicitation of Deceased and Living Organ Donors – An NEJM Sounding Board Article
DW Hanto, NEJM, March 8 2007, Vol 356 (10)
In exploring the ethics of patients directly soliciting donations of organs from willing strangers, Douglas Hanto advocates the controversial position that organ donors and their families should not be allowed to choose what to do with the organs. Instead, he proposes forcing all donors to donate to the recipient at the top of the organ transplant lists except in those cases where a pre-existing emotional relationship exists (such as between family members).
Cesarean Delivery and the Risk-Benefit Calculus – An NEJM Perspective Article
JL Ecker and FD Frigoletto, Jr., NEJM, March 1 2007, Vol 356 (9)
The authors analyze the possible factors involved in the increasing numbers of physicians who opt for cesarean delivery over the traditional vaginal birth. They examine both the soundness of the reasoning that justifies such a trend as well as the need to educate patients about the real risks and benefits involved in the choice of delivery method.
Pathways Through Medicine: Healthcare Outreach in Ethnic Communities
Diagnosing and treating ethnic communities is no easy task. In order to effectively treat diseases, physicians and community outreach workers must navigate the complex web of details created by factors such as the languages, cultures, and the specific, relevant details of the diseases. Programs for treating hepatitis B and asthma within the Asian and Pacific Islander (API) communities of large cities illustrate important approaches and common difficulties in treating ethnic communities.
Educating Innovators
Throughout history, innovation has been an integral–if less emphasized–element of the physician’s job description. Many great medical advances like asepsis and anaesthesia were in fact pioneered by doctors. Today, though, the environment in which they must innovate has been greatly transformed by both the rapid specialization of scientific research and regulations from agencies like the FDA. As a result, a handful of academic medical centers have taken the lead in educating future physician-innovators, offering focused curricula that forge stronger cross-institutional connections with the medical device industry.
Healthcare Gone Digital
Dr. Ming Shing Chiu finds it difficult to balance his personal relationship with his patients and the increasing burdens of HMO rules, especially now with electronic recordkeeping. Though electronic records ultimately benefit the patient, Dr. Chiu explores an unintended side effect which future doctors would be prudent to be wary of.
