The document summarizes the history of DES (diethylstilbestrol) use and advocacy in Australia. It describes how DES Action Australia was formed in 1979 in response to media reports about DES. The group advocated for women exposed to DES and their health issues. It also describes how some young girls in Australia were given DES in the 1960s to stunt their growth in an experimental trial. Their exposure was denied by health authorities for many years until news reports in 1997 led some of the exposed women to form the advocacy group Tall Girls Inc.
CASE 15 The Diethylstilbestrol Story An Investigation into the Evo.docxwendolynhalbert
CASE 15 The Diethylstilbestrol Story An Investigation into the Evolving Public Health Policy for Pharmaceutical Products
MARGARET ANN MILLER, EMILY BLECKER, AND MEGHAL PATEL
i Regulatory agencies such as the United States Food and Drug Administration (FDA) play an important role in promoting and protecting public health by preventing or limiting exposure to unsafe products. Unfortunately, laws and regulations that protect public health are rarely proactive. Most current laws, regulations, and policies governing the manufacture and sale of pharmaceutical drug products (drugs) were enacted following a public health disaster. Understanding how public health disasters have impacted the development of health laws and regulations is critical for understanding current public health policy in the United States and for developing a proactive, rather than reactive public health framework. This case study describes the tragic story of the prescription drug, diethylstilbestrol (DES). It involves numerous players in the public health arena including research scientists, regulators, pharmaceutical companies, physicians, lawyers, advocates, and of course, patients.
INTRODUCTION
In 1971, several physicians noted an alarming increase in the development of clear cell adenocarcinoma in teenage girls and young women. This rare and potentially deadly form of vaginal and cervical cancer had previously occurred mainly in women over 50 years of age. The only treatment was major invasive surgery to remove the uterus (hysterectomy) or vagina (vaginectomy). This surgery was not only emotionally and physically painful but sometimes not a cure. A few physicians began to search for the cause of this rare form of cancer, and one physician, Arthur Herbst, described a common link: all of the women developing clear cell adenocarcinoma were exposed to DES in utero.1 The implications of this finding were terrifying for the American public—millions of children might develop cancer or some other reproductive problem after an unknown length of time because their mothers took this prescription medication during pregnancy. Today there is still no test for detecting DES exposure and it is impossible to know how many people were, or will be, affected by the medication. DES remains one of the most significant public health disasters of the 20th century.
THE BEGINNING
Starting in the mid-1920s, scientists understood the action of natural estrogens and their potential utility for treating numerous conditions from cancer to wrinkles. The natural estrogens identified at that time were not water soluble and showed no activity when given orally. Several research scientists (many of whom were supported by pharmaceutical companies) began their search for an orally active form of estrogen. In 1938, British physician and chemist Charles Dodds and his team of scientists published a paper describing the synthesis of DES, a compound that showed estrogenic activity when consumed orally in t ...
Kiosk-Style Slide Presentation with some interactivity presented at Purdue University Teaching, Learning, and Technology Conference 2003. Must download to fully experience.
A presentation given by Prof. David Croaker & Eunice Gribben at the CHA Cofnerence in October 2012, The Journey, in the 'innovations in supporting chronically unwell children, young people and their families' stream.
Cleveland State University[email protected]Journal of Law WilheminaRossi174
Cleveland State University
[email protected]
Journal of Law and Health Law Journals
2001
Lessons Taught by Miss Evers' Boys: The
Inadequacy of Benevolence and the Need for Legal
Protection of Human Subjects in Medical Research
Donald H.J. Hermann
DePaul University
Follow this and additional works at: http://engagedscholarship.csuohio.edu/jlh
Part of the Medical Jurisprudence Commons
How does access to this work benefit you? Let us know!
This Article is brought to you for free and open access by the Law Journals at [email protected] It has been accepted for inclusion in Journal
of Law and Health by an authorized administrator of [email protected] For more information, please contact [email protected]
Recommended Citation
Donald H.J. Hermann, Lessons Taught by Miss Evers' Boys: The Inadequacy of Benevolence and the Need for Legal Protection of
Human Subjects in Medical Research, 15 J.L. & Health 147 (2000-2001)
http://engagedscholarship.csuohio.edu?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://engagedscholarship.csuohio.edu/jlh?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://engagedscholarship.csuohio.edu/lawjournals?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://engagedscholarship.csuohio.edu/jlh?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/860?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://library.csuohio.edu/engaged/
mailto:[email protected]
147
LESSONS TAUGHT BY MISS EVERS’ BOYS: THE
INADEQUACY OF BENEVOLENCE AND THE NEED FOR
LEGAL PROTECTION OF HUMAN SUBJECTS IN MEDICAL
RESEARCH
DONALD H.J. HERMANN1
Legal regulation and ethical constraints on medical research are again at the
forefront of public policy concerns. The reported deaths of a volunteer in a gene
therapy research program at the University of Pennsylvania and of a participant in an
asthma experiment at the Johns Hopkins Medical Center have raised issues of the
adequacy of government surveillance of medical research and the adequacy of
current practices eliciting voluntary informed consent from research participants.2
The recognition of the need for legal constraints on medical research and for
protection of human subjects was greatly influenced by the reports of the research
conducted by Nazi doctors and scientists.3 While no one denies the atrocities
committed under the guise of medical research in the Third Reich, there has also
been recognition of the significant abuse of research subjects in the United States,
most recently in the reports of the Federal Advisory Committee on Human Radiation
experiments.4 Perhaps the most publicized research involving failure to pr ...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
CASE 15 The Diethylstilbestrol Story An Investigation into the Evo.docxwendolynhalbert
CASE 15 The Diethylstilbestrol Story An Investigation into the Evolving Public Health Policy for Pharmaceutical Products
MARGARET ANN MILLER, EMILY BLECKER, AND MEGHAL PATEL
i Regulatory agencies such as the United States Food and Drug Administration (FDA) play an important role in promoting and protecting public health by preventing or limiting exposure to unsafe products. Unfortunately, laws and regulations that protect public health are rarely proactive. Most current laws, regulations, and policies governing the manufacture and sale of pharmaceutical drug products (drugs) were enacted following a public health disaster. Understanding how public health disasters have impacted the development of health laws and regulations is critical for understanding current public health policy in the United States and for developing a proactive, rather than reactive public health framework. This case study describes the tragic story of the prescription drug, diethylstilbestrol (DES). It involves numerous players in the public health arena including research scientists, regulators, pharmaceutical companies, physicians, lawyers, advocates, and of course, patients.
INTRODUCTION
In 1971, several physicians noted an alarming increase in the development of clear cell adenocarcinoma in teenage girls and young women. This rare and potentially deadly form of vaginal and cervical cancer had previously occurred mainly in women over 50 years of age. The only treatment was major invasive surgery to remove the uterus (hysterectomy) or vagina (vaginectomy). This surgery was not only emotionally and physically painful but sometimes not a cure. A few physicians began to search for the cause of this rare form of cancer, and one physician, Arthur Herbst, described a common link: all of the women developing clear cell adenocarcinoma were exposed to DES in utero.1 The implications of this finding were terrifying for the American public—millions of children might develop cancer or some other reproductive problem after an unknown length of time because their mothers took this prescription medication during pregnancy. Today there is still no test for detecting DES exposure and it is impossible to know how many people were, or will be, affected by the medication. DES remains one of the most significant public health disasters of the 20th century.
THE BEGINNING
Starting in the mid-1920s, scientists understood the action of natural estrogens and their potential utility for treating numerous conditions from cancer to wrinkles. The natural estrogens identified at that time were not water soluble and showed no activity when given orally. Several research scientists (many of whom were supported by pharmaceutical companies) began their search for an orally active form of estrogen. In 1938, British physician and chemist Charles Dodds and his team of scientists published a paper describing the synthesis of DES, a compound that showed estrogenic activity when consumed orally in t ...
Kiosk-Style Slide Presentation with some interactivity presented at Purdue University Teaching, Learning, and Technology Conference 2003. Must download to fully experience.
A presentation given by Prof. David Croaker & Eunice Gribben at the CHA Cofnerence in October 2012, The Journey, in the 'innovations in supporting chronically unwell children, young people and their families' stream.
Cleveland State University[email protected]Journal of Law WilheminaRossi174
Cleveland State University
[email protected]
Journal of Law and Health Law Journals
2001
Lessons Taught by Miss Evers' Boys: The
Inadequacy of Benevolence and the Need for Legal
Protection of Human Subjects in Medical Research
Donald H.J. Hermann
DePaul University
Follow this and additional works at: http://engagedscholarship.csuohio.edu/jlh
Part of the Medical Jurisprudence Commons
How does access to this work benefit you? Let us know!
This Article is brought to you for free and open access by the Law Journals at [email protected] It has been accepted for inclusion in Journal
of Law and Health by an authorized administrator of [email protected] For more information, please contact [email protected]
Recommended Citation
Donald H.J. Hermann, Lessons Taught by Miss Evers' Boys: The Inadequacy of Benevolence and the Need for Legal Protection of
Human Subjects in Medical Research, 15 J.L. & Health 147 (2000-2001)
http://engagedscholarship.csuohio.edu?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://engagedscholarship.csuohio.edu/jlh?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://engagedscholarship.csuohio.edu/lawjournals?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://engagedscholarship.csuohio.edu/jlh?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/860?utm_source=engagedscholarship.csuohio.edu%2Fjlh%2Fvol15%2Fiss2%2F3&utm_medium=PDF&utm_campaign=PDFCoverPages
http://library.csuohio.edu/engaged/
mailto:[email protected]
147
LESSONS TAUGHT BY MISS EVERS’ BOYS: THE
INADEQUACY OF BENEVOLENCE AND THE NEED FOR
LEGAL PROTECTION OF HUMAN SUBJECTS IN MEDICAL
RESEARCH
DONALD H.J. HERMANN1
Legal regulation and ethical constraints on medical research are again at the
forefront of public policy concerns. The reported deaths of a volunteer in a gene
therapy research program at the University of Pennsylvania and of a participant in an
asthma experiment at the Johns Hopkins Medical Center have raised issues of the
adequacy of government surveillance of medical research and the adequacy of
current practices eliciting voluntary informed consent from research participants.2
The recognition of the need for legal constraints on medical research and for
protection of human subjects was greatly influenced by the reports of the research
conducted by Nazi doctors and scientists.3 While no one denies the atrocities
committed under the guise of medical research in the Third Reich, there has also
been recognition of the significant abuse of research subjects in the United States,
most recently in the reports of the Federal Advisory Committee on Human Radiation
experiments.4 Perhaps the most publicized research involving failure to pr ...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
DES Action Australia
1. DES (diethylstilboestrol)
The experience in Australia and
the role of DES Action groups
Marian Vickers and Janet Cregan-Wood
DES Action Australia
Pharmacy Practice and Public Health - PHAR 4823
University of Sydney, March 21, 2017
2.
3. 2
Di Ethyl Stilboestrol (DES)
in Australia known as
Stilboestrol
On reflection the DES Action Australia story is a
result of serendipity, a confluence of circumstances
Integral to this is the role played by the media
4. 3
April 1971
DES emerged as a public health crisis in when it was discovered that DES daughters
were at risk of an aggressive, glandular cancer of the cervix/vagina because of their
in utero exposure to DES.
What happened in Australia?
From the consumer's viewpoint, and for all practical purposes, nothing!
September 1972
The response of the Australian health authorities was very laid back, if not negligent.
In September 1972 a small statement on DES by the Drug Evaluation Committee
appeared in the Medical Journal of Australia (MJA) “ ….As far as can be ascertained,
stilboestrol has not been used to any extent in this country for the management of
threatened abortion… It is reasonable to conclude that stilboestrol should not be
given in pregnancy...”
Exactly how this was “ascertained” is anybody’s guess, and probably was just that!
It was more creative thinking than based on empirical research.
5. 4
1976
Small isolated items on DES
appeared in Australian media
but led nowhere...
No contact details given
No follow-up possible
THE AGE
14 April 1976
THE SUN
30 January 1976
6. 1979
saw a convergence of different factors
In 1978 DES Action USA formed and was
disseminating comprehensive and accurate
information on adverse effects of DES
Joyce Bichler was the first DES daughter to
successfully sue a drug company. The court
case was being heard in 1979 in New York,
and there was considerable international
interest in it
An Australian journalist interested in the
court case was then briefed by Pat Cody of
DES Action USA on the wider issues around
DES exposure
In September 1979 DES seemingly
appeared out of nowhere when THE AGE
newspaper ran a series of scoops over
two days
15. 14
A Time of Confusion and Contradiction
The Media (Newspapers and TV) were presenting
comprehensive information on DES
Health Authorities and Doctors were caught out:
Initially denying DES was ever used on Australia
Then saying everyone affected had been notified and tested
We were caught in the middle
Do you believe the media?
They seemed to know the facts
or
Do you believe the doctors?
Doctors were repeating the authorities line that DES wasn’t used in Australia,
saying it was all a media beat up
16. 15
Union of Australian Women (UAW) to the Rescue
Again, a convergence of factors
Bon Hull, a women’s health activist, was
writing a book In Your Own Hands, published in 1980
Wendy Lowenstein read an early proof of Bon’s book
and thought she might be directly involved (i.e. a DES mother)
When the UAW asked around as to which women’s groups
were taking this issue up, the answer was none.
So the UAW assigned Yvonne Smith to oversee
the DES project....
2004 Reunion DES Action and UAW - 25th Anniversary of DES Action
....and the UAW organised and publicised a public meeting
18. 17
1979 DES Action established
When DES Action formed in 1979 we were immediately faced with the “myth”
from the health authorities that DES wasn’t used extensively in Australia.
The media was told everyone affected had been notified and were being
screened (that was certainly news to us!)
DES Action has always been very much about sharing stories and
information; and, most importantly, supporting each other
Our immediate focus was on finding knowledgeable, sympathetic doctors;
where to get the correct screening; hints of how to get medical records…
Also, at the same time, we were experiencing the ever-widening devastating
effects of DES exposure: having to have repeated cervical/pelvic screenings,
biopsies, three-monthly call-backs … infertility tests, repeated miscarriages,
pregnancy loss, very prem babies.. Endometriosis… ovarian cysts…
haemorrhaging…premature menopause…an increased incidence of rare and
diverse autoimmune conditions…
19. 18
Our newsletter DESPATCH records our activities,
struggles, frustrations over the years
The first issue of DESPATCH outlines our activities
over that first hectic year
In 1983 we appeared on 60 Minutes
A Plague on our Children
In 1985 a comprehensive article,
DES: The wonder drug you should wonder about,
was published in the journal of
The Health Issues Centre
20. 19
A problem immediately apparent
when the group first formed was
access to medical records.
Records suddenly disappeared,
vanished
A number of women reported
being able to obtain verification of
DES exposure through pharmacy
records
22. 21
DISCOVERING THE TALL GIRLS by Marian Vickers
To treat health young prepubescent girls with a known carcinogen to stunt their adult
height sounds like a bizarre science fiction experiment, but it is unfortunately true.
In the early 1980s DES Action members were devouring information about the history
and use of DES. One aspect of interest was its use in veterinary practice.
We first heard of DES being used to inhibit the adult height of tall young girls almost by
accident. In 1980 a sister of DES Action member, Clare Green, was studying veterinary
science at Melbourne University. One of her lecturers, Dr Anne Jabarah, had researched
DES during the 1960s as part of her Masters and PhD studies.
Clare rang Dr Jabarah and spoke to her at length about her research findings.
Dr Jabarah commented that the published articles caused a great deal of interest
internationally but not in Australia. Almost as an afterthought, she mentioned the
Royal Children’s Hospital (RCH) in Melbourne had requested details of her research,
as they were thinking of using DES to inhibit the growth of
young girls. She said she had often wondered whether they
went ahead with the treatment.
Clare, on behalf of DES Action, wrote to the RCH
seeking clarification on the matter.
A letter was received from the medical director of the
RCH stating that DES had never been used for such a
purpose.
23. 22
DISCOVERING THE TALL GIRLS continued
In addition, Clare was asked to go into the Victorian Health Department to meet with a
department spokesperson. The doctor told Clare that she had looked into the matter and
there was absolutely no evidence that DES was used for this purpose. We were thus
reassured, both in writing and in person, that no such trial had taken place.
So it came a quite a shock several years later when I was contacted by a young woman who
had been part of this non-existent trial. She had attended the RCH and had been given DES
to stunt her growth. She was in her early 20s and had been diagnosed with advanced
invasive cervical cancer. As she was a nurse she knew this was very rare, particularly as she
had none of the known risk factors for the disease.
When I asked her how she found out about DES Action she said her treating doctor (a well-
known Ob/Gyn) had suggested she ring. Obviously he had made the connection between
her DES exposure as a young girl and the subsequent cervical cancer.
In subsequent years (to 1997) we received a handful of further inquiries from “tall girls”
requesting information. The health concerns of these women had an all-too-familiar ring:
dysplasia, endometriosis, ovarian cysts, aggressive cancers (cervix and breast), impaired
fertility, and premature menopause (i.e. occurring during their late 20s).
I can’t really describe my feelings when I opened The Age newspaper on 27 June 1997 and
read on page 1: Hormone tests on teenage girls referred to inquiry.
A sense of relief – that the truth would finally be known – tall girls were given DES to stunt
their growth.
Also it brought back the anger and frustration Clare and I experienced in the early 1980s
when our inquiries were fobbed off by the medical establishment and health authorities.
30. 29
TALL GIRLS INC by Janet Cregan-Wood
It came out of blue. A front page story in THE AGE on 27 June 1997.
The HERALD SUN newspaper also ran a similar story. This provided the avenue
for women who remembered their treatment to phone the journalists with their
concerns and stories, having identified themselves as having been children who
were treated. The journalists at THE AGE, provided the telephone number for
Marian Vickers, Convenor of DES Action Australia.
Marian kept the contact numbers of those who rang her and gave them out to
the treated women as they rang. A phone tree developed enabling women to
contact each other. Each had thought they had been the only one who had
received treatment. To share their story with others for the first time was
powerful, emotional. All, it seemed, had experienced health problems, in
particular gynaecological and reproductive issues.
On 9 July 1997 in the Letters Section of THE AGE, Graeme Barnes, Scientific
Director of The Royal Children’s Hospital Research Foundation referred to the
trial the Tall Girls had been unwittingly a part of, as ‘public spirited volunteers’.
When the first five women and three of their mothers met to form DES Tall Girls, they embarked
upon their campaign, rejecting Graeme Barnes’ letter, demanding a long term epidemiological
follow up. We wanted to know that what was done to us was without fault medically and ethically.
From the beginning we took ownership of our cause, not wanting to be viewed as victims, to be ‘the
primary stakeholder’s and to ask “What happened to us, why and what are the long term effects of
our treatment”. A phone number was given in our responding letter to Barnes’s in THE AGE.
Over the next few weeks there was a cascade of phone calls from women who remembered their
treatment.
33. 32
The Tall Girls reported having experienced infertility,
miscarriages, ovarian cysts, endometriosis, cancer, eating
disorders, depression and muscular skeletal disorders.
No two stories had the same cluster of effects but it was
impossible to discount the commonalities of the narrative.
We also discovered that ethinyloestrodial (EE) was used to
treat Tall Girls, as well as DES.
The forming of the Tall Girls group can be viewed on
SBS Insight, which aired on 4 September 1997
https://www.youtube.com/watch?v=mpnqS95qyJk&t=1344s
The Tall Girls’ advocacy led to a world-first epidemiological
study into the long-term effects of oestrogen treatment to
stunt growth, funded by the NHMRC.
This is outlined in the 2001 article
Participation, Empowerment and Effectiveness:
The Tall Girls Inc. Experience
by Ed Wolf
34. 33
I always thought that prescription drugs were safe.
And, furthermore, if a drug was suddenly found to be
harmful, I thought you would be informed. After all, they
recall cars if they are found to be faulty, if they put lives at risk.
And they recall and issue public warnings if salami is found to have salmonella…
So why did I become an activist with DES Action? I think it was the shock, the sense of injustice
Why weren't we told? Why weren't we warned? Because not only were we not warned, the
health authorities actively put out misleading information, and actively dismissed us. And this
continues today…
The experience lead to a shift in my perception of how the world works.
And why have I stayed involved? Because in a sense I have no choice: I am a DES daughter
and it appears my daughters are "DES granddaughters".
Recently there has been renewed interest in the DES population by the international scientific
community. DES is now recognised as an endocrine disruptor. Many scientists believe endocrine
disruption will be the most important global health issue of the future.
- Marian Vickers
35. 34
Herbst A, Ulfelder H, Poskanzer D (1971) Adenocarcinoma of the vagina: Association of maternal
stilbestrol therapy with tumor appearance in young women. NHJM 284 (16): 878-88
http://www.nejm.org/doi/full/10.1056/NEJM197104222841604#t=articleTop
Hoover RN, Hyer M, Pfeiffer RM, et al. (2011) Adverse health outcomes in women exposed in utero to
diethylstibestrol. NEJM. 365:1304-14. http://www.nejm.org/doi/full/10.1056/NEJMoa1013961
Newbold RR, et al (1998) Increased tumors but uncompromised fertility in the female descendants of
mice exposed developmentally to diethylstilbestrol. Carcinogenesis 19: 1655-1663
http://carcin.oxfordjournals.org/content/19/9/1655.long
Newbold RR, et al (2000) Proliferative lesions and reproductive tract tumors in male descendents of
mice exposed developmentally to diethylstilbestrol. Carcinogenesis 21: 1355-1363
http://carcin.oxfordjournals.org/content/21/7/1355.long
Newbold RR (2004) Lessons learned from perinatal exposure to diethylstilbestrol. Toxicol Appl
Pharmacol.199:142–150. http://www.ncbi.nlm.nih.gov/pubmed/15313586
McLachlan JA (2006) Commentary: Prenatal exposure to diethylstilbestrol (DES): a continuing story.
Int. J. Epidemiol. 35 (4): 868-870. http://ije.oxfordjournals.org/content/35/4/868.full
Crain DA, et al (2008) Female reproductive disorders: the roles of endocrine disrupting compounds
and developmental timing. Fertil Steril. 90(4): 911–940
https://www.ncbi.nlm.nih.gov/pubmed/18929049
Vickers M (2004) So why did I become an activist with DES Action?
http://www.womensweb.com.au/sources/Later%20Stories/Marian%20Vickers.htm
DES Resource List
36. 35
TALL GIRLS
Wolf E (2001) Participation, Empowerment and Effectiveness: The Tall Girls Inc. Experience
Health Issues 69: 32-35
Venn A, el al. (2004) Oestrogen treatment to reduce the adult height of young girls: long term effects
on fertility. Lancet 364 (9444):1513-18. http://www.ncbi.nlm.nih.gov/pubmed/15500896
Rayner J, et al (2010) The medicalisation of ‘tall’ girls: A discourse analysis of medical literature on
the use of synthetic oestrogens to reduce female height. Social Science & Medicine 71 1076-1083.
https://www.ncbi.nlm.nih.gov/pubmed/20678835
Bruinsma FJ, et al (2011) Looking back in time: conducting a cohort study of the long-term effects of
treatment of adolescent tall girls with synthetic hormones. BMC Public Health 11 (Suppl 5): S7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247030/
Hendriks AEJ, et al. (2011) Fertility and Ovarian Function in High-Dose Estrogen-Treated Tall Women.
J Clin Endocrin Metab 96(4):1098-1105. http://www.ncbi.nlm.nih.gov/pubmed/21289262
Benvi E, et al. (2014) Risks of malignant and non-malignant tumours in tall women treated with high-
dose oestrogen during adolescence. Horm Res Paediatr 82(2):89-96
https://www.ncbi.nlm.nih.gov/pubmed/24924304
Vickers M (2014) When Being a Tall Girl was a Medical Condition: DES and the Tall Girls Hormones
Matter https://www.hormonesmatter.com/des-used-stunt-growth-tall-girls/
37. 36
OTHER
Perera F, Herbstman J (2011) Prenatal environmental exposures, epigenetics, and disease. Reprod
Toxicol 31(3): 363-373 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171169/
Csoka AB, Szyf M (2009) Epigenetic side-effects of common pharmaceuticals: A potential new field in
medicine and pharmacology. Medical Hypotheses 73:770–780
http://www.ncbi.nlm.nih.gov/pubmed/19501473
Disease Mongering http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030191
BOOKS
DES Voices: From Anger to Action (2008) by Pat Cody
Normal At Any Cost: Tall Girls, Short Boys, and the Medical Industry’s Quest to Manipulate Height
(2009) by Susan Cohen and Christine Cosgrove
The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth (2003)
by Barbara Seaman
https://www.youtube.com/watch?v=ySCHlN1Ci5o
Our Stolen Future (1996) by Theo Colborn, Dianne Dumanoski & John Peterson Myers
http://www.ourstolenfuture.org/
Selling Sickness: How drug companies are turning us all into patients (2005) by Ray Moynihan & Alan
Cassels http://ahrp.org/selling-sickness-pharma-industry-turning-us-all-into-patients/
38. 37
VIDEOS
A Plague on our Children
60 Minutues 1983
https://www.youtube.com/watch?v=PNFnOjuoGLw&feature=youtu.be
Beating cancer one lap at a time
https://www.youtube.com/watch?v=fcvgn4lJ8R0
Tall Girls exposed to DES and EE
SBS Insight 04.09.97
https://www.youtube.com/watch?v=mpnqS95qyJk
Endocrine Disruptors: Sexy Stuff
https://www.youtube.com/watch?v=d2x9I7UTqBM