German court circumcision ban meets wave of criticism

Reuters – Thu, Jun 28, 2012 BERLIN (Reuters) - Germany's foreign minister added his voice on Thursday to a chorus of criticism of a court decision to ban the circumcision of young boys for religious reasons, arguing that such traditions must be permitted in a tolerant society.

"Germany is an open-minded, tolerant country where religious freedom is firmly established and religious traditions like circumcision are considered an expression of religious pluralism," Guido Westerwelle told the daily Bild in an interview to be published in its Friday edition.

A court in Cologne ruled on Tuesday that involuntary religious circumcision should be illegal as it could inflict serious bodily harm on people who had not consented to it.

The ruling, which applies only to the area around the western city of Cologne but sparked fears among Muslims and Jews in particular that other German states could copy the ban, said boys can consciously decide to be circumcised later in life.

According to the court ruling, "the fundamental right of the child to bodily integrity outweighs the fundamental rights of the parents".

Westerwelle said the ruling caused "irritation" around the world after being reported in the international media.

The Turkish newspaper Hurriyet's website said Turkish European Minister Egemen Bagis had criticized the German ruling, saying that circumcision was a matter of freedom of religion and conscience.

"If German judges have a problem understanding this issue, we can send our scientific circumcisers, we can give them lessons in how to circumcise," he was quoted as saying.

"We are ready to make any contribution for a country that is a friend and ally. But it is not possible for us to accept this ruling as a fait accompli ... God willing, this verdict will be changed," Bagis said.

The Central Council of Jews in Germany called the ruling an "unprecedented and dramatic intrusion" on religious freedom and the Central Council of Muslims in Germany called it "blatant and inadmissible interference" in the rights of parents.

Germany's two main Christian churches also criticized the Cologne court ruling, the Catholic Episcopal Conference calling it "extremely disconcerting".

"To ban circumcision is a serious attack on religious freedom," said Catholic Bishop Heinrich Mussinghoff.

The Evangelical Church's Hans Ulrich Anke said: "Religious freedom and parents' right to choose how to educate their children have not been weighed against the fundamental right of the child to bodily integrity".

The United Nations' special rapporteur on religious freedom, Heiner Bielefeldt, told German radio the court's reasoning was "nonsense".

(Edited by Stephen Brown, editing by Tim Pearce)

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Four-in-one AIDS drug gets the OK in clinical trial

Four-in-one AIDS drug gets the …

An experimental once-daily pill that combines four drugs to fight HIV is as safe and effective as commonly-prescribed treatments against the AIDS virus, researchers reported in The Lancet Friday.

Doctors tested the new drug, called Quad, for the third and final phase in which new pharmaceutical products are vetted for safety and effectiveness.

Publication in the British journal follows a recommendation in May by a US Food and Drug Administration (FDA) advisory panel to approve Quad for previously untreated adults infected with HIV-1. A final decision is expected by August.

The first trial entailed testing Quad against a three-in-one pill, Atripla, which since 2006 has been a standard treatment for the human immunodeficiency virus (HIV).

Researchers enrolled 700 patients in centres in North America and assigned them randomly to either Quad or Atripla.

After 48 weeks of treatment, 88 percent of Quad patients had suppressed viral loads to below detectable levels, against 84 percent in the Atripla group.

Side effects were infrequent but similar in both groups. Among Quad patients, mild nausea was the more common adverse event, whereas with Atripla, symptoms were likelier to be dizziness, abnormal dreams or insomnia and skin rashes.

In the second trial, 708 patients were enrolled in Australia, Europe, North America and Europe.

Patients were either given Quad or a widely recommended therapy comprising the molecules atazanavir (ATV), boosted by ritonavir (RTV), together with emtricitabine (FTC) and tenofovir disoproxil fumarate, or TDF.

After 48 weeks, 90 percent of the Quad group had viral levels below detectable levels compared to 87 percent in the other drug group.

Only 3.7 percent of patients in the Quad group stopped treatment because of side effects, compared with 5.1 percent in the other group. On the other hand, the number who reported kidney complications in the Quad group was relatively higher.

Quad comprises FTC and TDF, along with a drug called elvitegravir (ETV), which is designed to inhibit HIV replication. The fourth ingredient is a "pharmacoenhancer" called cobicistat to boost the effectiveness of ETV.

The movement towards a single once-daily pill to suppress HIV has a huge benefit for patients, say AIDS researchers.

When the first antiretroviral drugs emerged in the 1990s, patients had to take a dozen tablets a day or more, a "pill burden" that meant many forgot to follow the entire treatment.

"Patient adherence to medication is vital, especially for patients with HIV, where missed doses can quickly lead to the virus becoming resistant," said Paul Sax of Harvard Medical School, who led the first study in Friday's Lancet.

"Our results provide an additional highly potent, well-tolerated treatment option, and highlight the simplicity of treatment resulting from combining several antiretrovirals in single pill."

Quad is made by the US pharmaceutical giant Gilead Sciences, which also funded the trials, a practice that is relatively common in drug development.

Clinical tests for new drugs have to go through a three-phase process that is scrutinised by independent assessors and government regulators for safety and objectivity. Publication of the research in a peer-reviewed journal is a final step in the procedure.

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German verdict to delay circumcision, not ban it, jurist says

Reuters – Fri, Jun 29, 2012 PARIS (Reuters) - A widely criticized German court verdict on religious circumcision this week aims only to delay the act, not ban it, and is not directed against any faith, a jurist with a leading role in the legal debate said on Friday.

The operation does serious bodily harm and only males old enough to consent to it freely should undergo it, said Holm Putzke, law professor at Passau University in southern Germany.

Using arguments Putzke has published in recent years, a court in the western city of Cologne ruled on Tuesday that the circumcision there of a Muslim boy who suffered post-operative bleeding had violated a German law against causing bodily harm.

Jewish, Muslim, Catholic and Protestant leaders in Germany denounced the ruling as a serious intrusion on religious freedom. Even Germany's foreign minister spoke out, saying such faith traditions must be allowed in a tolerant modern society.

"I can understand that this verdict has irritated people around the world, but this irritation can be resolved if people look at the reasons for it," Putzke told Reuters by telephone.

"Nobody wants to ban religious circumcision in Islam and Judaism, not at all," he said. "It should just be decided by those who undergo it."

Some German media initially reported the verdict applied only to Jews, which may have added to the emotion of some first reactions, he said. Suggesting opposition to circumcision was aimed against Jews was dishonest, he said.

Germany is home to about 4 million Muslims and 120,000 Jews.

Jews circumcise male infants eight days after birth to recall their covenant with God. The time for Muslim circumcision varies according to family, region and country.

The Cologne court ruling said the four-year-old boy in the case was not old enough to consent to have part of his body removed permanently and his parents should have let him decide when he got older. It gave no minimum age for this.

LIVELY DEBATE AMONG DOCTORS

Putzke said an article he published five years ago in a German medical journal led to lively debates among doctors, especially those called on to perform circumcisions.

"It quickly became clear that a large majority of doctors in clinics objected to medically unnecessary circumcisions," he said. "They said they went against the Hippocratic Oath."

The doctor who treated the boy for post-operative bleeding reported the case to the police, leading them to bring charges against the person who performed the faulty circumcision.

The Cologne judge consulted academic articles in legal and medical journals before making his decision, Putzke said.

"This is not simply a verdict from some misguided court," he added. "Somebody sat down and thought long and hard about the fundamental legal rights involved."

The verdict, which is valid only in the Cologne area, could "send a signal," he said, but it was not clear if other courts would follow this example. He did not know of any similar cases before other courts in Germany.

Putzke said he began studying the issue of circumcision and children's rights after his law professor pointed out to him and other students that violence against children was widely condemned in all cases but these.

"Even the Muslim students were surprised by this," he said.

He hoped religious communities would be open to debating the issue and not refuse to consider any change to their traditions.

Putzke expressed surprise that many people had written to him after the court verdict was announced to support his view.

"I've received thousands of emails in the past few days, from all over the world," he said. "The most remarkable thing is that the emails from Israel were the most balanced and moderate."

(Reporting By Tom Heneghan; Editing by Jon Boyle)

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Supreme Court Ruling Sets Stage for Full Rollout of Health-Care Reform Law

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Health Tip: Is Your Pregnancy Higher Risk?

HealthDay – Fri, Jun 29, 2012 (HealthDay News) -- If you're pregnant, a series of physical and demographic factors may dictate that your pregnancy is "high-risk" and requires special care.

The Womenshealth.gov website offers these examples of factors that can make a pregnancy high-risk:

Being young or being older than age 35.Being underweight or overweight.Having had complications during a prior pregnancy.Having had at least one chronic health problem before pregnancy, such as diabetes, high blood pressure, cancer, HIV or an autoimmune disorder.Expecting twins or triplets, etc.

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Study of Retired NFL Players Finds Evidence of Brain Damage

HealthDay – Fri, Jun 29, 2012 FRIDAY, June 29 (HealthDay News) -- Tests performed on a group of retired NFL players revealed that more than 40 percent suffered from problems such as depression and dementia, adding to a growing pile of evidence that repeated sports-related head traumas can lead to lasting neurological issues.

Analyzing 34 ex-professional football players (average age 62) on benchmarks such as memory, reasoning, problem-solving and behavior, researchers from the Center for Brain Health at the University of Texas at Dallas found that 20 tested normal while the rest suffered from depression, various deficits in memory/thinking or a combination of these issues. Twenty-six of the players also underwent MRI scans.

"We picked up that many guys were depressed but didn't know it," added study author Dr. John Hart, medical science director at the center. "The cognitive impairments . . . were more than what's expected for their ages. A lot had damage to their brain's white matter, so for us it's a real clue or marker to look for."

Hart is scheduled to present the findings Friday at the National Athletic Trainers' Association (NATA) annual meeting in St. Louis. Research presented at scientific meetings should be considered preliminary until it is published in a peer-reviewed medical journal.

An estimated 300,000 sports-related concussions occur in the United States each year, and mounting attention is being paid to the neurological toll of those injuries on former professional athletes. In June, a massive bundle of lawsuits representing more than 2,100 National Football League players was filed against the league, claiming that the NFL hid information linking football-related head injuries to permanent brain damage.

Hart's study involved ex-NFL athletes hailing from the North Texas region. For comparison purposes, the researchers also looked at the brains of 26 people with no signs of mental deficits, selected from the general population and matched for age, education and IQ.

Of the eight former players who were found to have depression -- the finding that most surprised Hart -- most didn't exhibit the mood issues such as sadness that are typically associated with the condition, he said.

Instead, "there was a lack of energy, initiative or sex drive and disrupted sleep, with weight gain or loss," Hart said. "They would ruminate or get anxious about stuff, but they weren't crying. They were shocked or surprised

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Residents as Good as Fully Trained Docs if Properly Supervised: Study

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Gay or Straight, Parents Too Tired for Sex, Study Suggests

HealthDay – Fri, Jun 29, 2012 FRIDAY, June 29 (HealthDay News) -- Heterosexual couples often have trouble with sex and intimacy issues after they become parents, and a new study suggests that gay parents face some of the same challenges.

"When gay couples become parents, they become very focused on the kids, they are tired, there is less time for communication and less desire for sex," Colleen Hoff, a professor of sexuality studies at San Francisco State University, said in a university news release. "They go through a lot of the same changes as heterosexual couples who have kids."

An estimated one in five gay male couples nationwide is raising children. For the new study, 48 gay male couples who are raising children together were interviewed and asked questions about their lives.

"We found that gay fathers have less time for sex and less emphasis on sexuality, which could mean they are at less risk for HIV," Hoff said. "Many fathers said they feel a sense of responsibility toward their children which motivates them to avoid risky sexual behavior."

Not many of the men were concerned about the changes in their sex lives, according to the report published in the June issue of the journal Couple and Family Psychology.

"From the fathers we studied, there was this pragmatic acceptance that this is what happens at this stage of life," Hoff pointed out.

Hoff and colleagues also found that the men tended to follow the same rules about sexual activity outside their partnership after becoming parents as they did before.

"There wasn't the shift that we thought we might find," Hoff said. "For the most part, those who were monogamous before becoming parents said they stayed with that arrangement. Those who had open relationships before having children reported that they kept to that agreement."

The findings suggest that gay male parents who are in open relationships might be less willing to talk to others, such as physicians, about the choices they've made.

"Some men felt that there is this assumption that if you are a gay parent you are monogamous," Hoff explained. "This kind of stigma around gay parents' sexuality could be a concern if gay fathers are reluctant to talk to their physician about their sexual agreement and get tested for HIV."

More information

For more about parenting, visit the U.S. National Library of Medicine.

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Court's Verdict on Health-Care Reform Holds Surprises, Legal Experts Say

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Few Patients Should Get Metal-on-Metal Hip Implants, FDA Panel Says

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Minorities Less Likely to Use Hospice Care: Study

HealthDay – Fri, Jun 29, 2012 FRIDAY, June 29 (HealthDay News) --Minority patients with heart failure are less likely to use hospice care than whites, new research finds.

Hospice provides palliative care for the terminally ill. The goal is to ease pain and discomfort, and to focus on quality of life as death approaches. Overall, use of hospice care is increasing, according to researchers from Indiana University School of Medicine.

Their study found that nonwhite Medicare patients with heart failure were 20 percent less likely to enroll in hospice than white patients. Nonwhite patients were also more likely to drop out of hospice care than whites.

"When considering end-of-life care options, it is important to consider hospice services at home, in nursing homes or in hospice facilities," study author Dr. Kathleen Unroe, a scientist with the Indiana University Center for Aging Research, said in a university news release. "Our findings highlight that there is a significant difference between how white patients and nonwhite patients and their families utilize hospice services."

The study, which looked at records on nearly 220,000 heart failure patients on Medicare, was published in the June issue of the American Heart Journal.

Nearly 1.6 million people received hospice services in 2010, according to the National Hospice and Palliative Care Organization. About 42 percent of all deaths in the United States were under the care of a hospice program in 2010.

More information

The U.S. National Institutes of Health provides more information on hospice care.

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Health Tip: Reduce Your Risk of a Herniated Disk

HealthDay – Fri, Jun 29, 2012 (HealthDay News) -- The spine is comprised of a series of hard bones called vertebrae. Sandwiched between them are soft, spongy pads called disks, which allows the spinal column to bend.

But if a disk ruptures (herniates) and the center pushes through the outer edge toward the spinal canal, it can put pressure on nearby nerves, causing pain and discomfort.

The American Academy of Orthopaedic Surgeons offers these suggestions to help prevent a herniated disk:

Avoid lifting with your back. Lift with your leg muscles instead, holding the object close to you.Don't smoke.Shed excess weight, which can strain the back.Avoid strenuous activities that are repetitive in nature.

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