Loss of a Hero in Fertility

Mr. Frank Palopoli, the chemist who developed a drug to treat infertility and subfertility due to anovulatory tendencies died this past Saturday.  He was 94. The drug he helped into existence, Clomiphene citrate, which came to be marketed as Clomid, helps to induce ovulation. Due to it’s safe and effective ability to address infertility through the stimulation of natural hormone production it has been placed on the World Health Organization’s List of Essential Medicines, and remains the only ovulation inducer included. Though the drug was first developed in Palopoli’s lab in 1950 it was took 17 years to come to market, and remains in use today.

It has been shown that the use of clomiphene citrate, in women who experience anovulatory infertility, can increase the chances of pregnancy such that their fertility during treatment can be considered normal. This has allowed many people that previously would have been unable to conceive to do so either naturally or through in vitro fertilization or intrauterine insemination. Up to 80% of anovulatory infertility cases treated with this drug have been shown to be successfully addressed.

More recent research has examined clomiphene citrate as a possible treatment for hypogonadism, the loss of function in the gonads and subsequent decrease in testosterone levels, in men. This alternative use for the drug Mr. Palopoli played an integral role in developing, shows promise and may further extend the impact of his contributions to the collection of drugs used today.

The use of clomiphene citrate and other drugs that induce ovulation has the potential to over stimulate the release of eggs and cause an increase in the rate of multiple pregnancies. Because multiple pregnancies carry a greater risk for both the expectant mother and her children the use of Clomid has also been linked to the abortion debate and the ethics of pregnancy monitoring. The use of this and other fertility therapies remain an important topic in medical ethics.

The group of organic chemists he headed worked under the William S. Merrell Company and contributed to the development of several other agents including triparanol and tamoxifen (researched as possibilities for the treatment of high cholesterol and breast cancer respectively). Clomiphene citrate has now been used by millions of people worldwide.

References: 

Kousta, E. "Modern Use of Clomiphene Citrate in Induction of Ovulation." Human Reproduction Update 3.4 (1997): 359-65. Web.

Roberts, Sam. "Frank Palopoli, Who Aided Fertility With Clomid Drug, Dies at 94." The New York Times. The New York Times, 11 Aug. 2016. Web. 11 Aug. 2016.

Shabsigh, Ahmad, Young Kang, Ridwan Shabsign, Mark Gonzalez, Gary Liberson, Harry Fisch, and Erik Goluboff. "Clomiphene Citrate Effects on Testosterone/Estrogen Ratio in Male Hypogonadism." The Journal of Sexual Medicine 2.5 (2005): 716-21. Web.

"WHO Model Lists of Essential Medicines." World Health Organization. World Health Organization, 1 Apr. 2015. Web. 11 Aug. 2016.

Analyzing Illegal and Refugee Immigration from a Public Health Perspective

Immigration has been the topic of conversation across the political sphere as of late. The combination of the European migration crisis and the porous southern US border has brought about a fierce debate as to what should be done socially and economically with immigrants. However, one aspect of our nation’s refugee acceptance and illegal immigration issue that has not been discussed as frequently is the impact on public health.

The United States has worked for decades to eradicate some of the diseases that frequently plagued the general population. Through vaccination, new sanitation standards, and updates to dated public health practices, we have eliminated many of the diseases that are still prevalent in other nations. Unfortunately, it is possible that the massive amount of undocumented immigrants entering our country unscreened could cause a spike in previously nonexistent illnesses.

According to multiple reports released over the past few years, including one released on World Migrant Day, the number of tuberculosis, measles, whooping cough, mumps, scarlet fever, and bubonic plague cases has increased. Many healthcare professionals have made a direct link to illegal immigration. Below are a few of the statistics:

Tuberculosis: Up 1.7% in 2015 after 23 years of decline

Measles: 667 Cases in 2014 after eradication in 2000

Whooping Cough: 32,971 cases in 2014, 30 times the amount in 1976

Mumps: 688 cases in 2015, after a 99% decrease in prevalence in 1967

    All of these diseases have been linked to incoming refugees and undocumented immigrants through the southern border. Many of the camps that house illegal minors are plagued by disease. In 2014, former Congressman Phil Gingrey (R-GA) wrote a scathing letter to Congress about the lack of transparency regarding disease transmission among immigrants. He cited reports of Border Patrol agents contracting diseases from the children. One major news station even reports that tuberculosis is prevalent in multiple camps, citing anonymous reports from healthcare workers employed. Not only is this detrimental to health of Americans, but also the health of the immigrants.  

What is the Solution?

    A significant amount of regulation is required in order to halt the spread of these infectious diseases. Currently, refugees are not required to have any vaccines prior to entering the United States. This poses a massive risk to our public health, as the MMR vaccine was directly responsible for eradicating measles after it was required by law. With potential disease carriers entering the U.S. in large numbers, it is almost guaranteed that the public will encounter new illnesses more frequently than before. One of the first steps in preventing further outbreaks is to halt refugee migration and develop a comprehensive screening system for communicable diseases. Additionally, vaccination should be required for all refugees entering the country. The combination of these two processes would eliminate the threat that refugees currently pose to public health.

With respect to the southern border, the U.S. government needs to reduce the number of undocumented immigrants entering the country by a significant amount. There is no way to analyze the health of individuals who have entered and now remain in the country illegally. The only way to prevent diseases from coming up through the southern border is to cut down on illegal immigration.

    Our policy with regard to vaccination and screening significantly differs between migrants and refugees. Many vaccinations are required for United States immigration. This, combined with health screening, has resulted in an extremely small percentage of communicable diseases being brought into our country via legal immigration.

    In short, the massive importation of refugees and illegal aliens into the nation is a very real threat to public health. A comprehensive reform to our refugee health policies and border security is essential to prevent the reoccurrence of deadly communicable diseases. Let’s not decimate the hard work of public health workers before us in their successful efforts to eradicate these illnesses.

References:

“Guidelines for Evaluating and Updating Immunizations During the Domestic Medical Examination for Newly Arrived Refugees.” Centers for Disease Control. 11 June, 2015.

“Illegal Alien Minors Spreading TB, Dengue, Swine Flu.” Judicial Watch. 8 July, 2014.

“New Vaccination Criteria for U.S. Immigration.” Centers for Disease Control. 29 March, 2012.

“Six Diseases Return to US as Migration Advocates Celebrate ‘World Refugee Day.’” Breitbart. 19 June, 2016.

AIDS 2016

What if I told you I was a citizen?
A citizen of a universe
A universe like no other
No other place could match it
Match its harmony and freedom
Freedom of speech, sexual orientation and status
Status of being HIV positive or negative,
Black or white, gay, straight or bisexual
Male, female or transgender

What if I told you how life changing it was
It was a hub of information, truth and dreams
Dreams of reaching 90-90-90 goals
Goals where we want to end HIV/AIDS as a pandemic by 2030
2030 – 2016 equals 14 years of dedication
Dedication to advocacy, activism, relentless volunteerism, access
Access to reproductive health commodities, to medication

What if I told you that I was in a room full of people?
People whose passion for fighting this war against HIV/AIDS is unmatched
We matched, yes we did, screaming ‘Sex work is work’
F Word
Proclaiming ‘Treat All’
H Word
Everybody is got a right to be who they are
And yes we said everybody who walks through those doors is entitled to treatment!

I mean all we do is debase each other
I see all we do is discriminate against each other
I’m whisper ‘NO NO NO, lets love each other’
To my colleague, sharing these chairs with one another
On stage Elton John preaching ‘Let’s come together’
Our Benoni girl pleading ‘let’s not have another’
Coz we already had the other
Twice, SA host International AIDS conference

What if I told you I’m still a citizen of that universe?
And that I am of the generation
That will end HIV/AIDS

Obesity Rates for Women Increase as Men Plateau

The National Health and Nutrition Examination Survey (NHANES) is a survey conducted through the Centers for Disease Control and Prevention and the National Center for Health Statistics that collects data on the prevalences of various diseases. Every two years, a sample of over 5,000 people from 15 different counties are surveyed around the country as a representation of the demographics of the general population. NHANES uses a stratified, multistage sample of non-institutionalized civilian residents and is comprised of an at-home questionnaire and standardized health examination performed by trained individuals (NHANES). The age-adjusted prevalence of obesity in 2013-2014 was 40.4% among women and 35.0% among men. For morbid obesity, the rates were 5.5% and 10% for men and women, respectively (JAMA). The overall obesity prevalence showed that while trends in male obesity have somewhat stabilized since 2005, there is a significant, linearly-increasing trend for women (JAMA).

JAMA. (n.d.). Trends in Obesity Among Adults in the United States, 2005 to 2014. Retrieved June 10, 2016, from http://jama.jamanetwork.com/article.aspx?articleid=2526639

NHANES. (2015). Questionnaires, Datasets, and Related Documentation. Retrieved June 10, 2016, from http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm