Surgical removal of a gigantic abdominal mass: a multidisciplinary approach.

BACKGROUND: Ovarian cystadenomas are common benign ovarian neoplasms that rarely present as gigantic abdominal masses. A variety of intraoperative and postoperative challenges may be encountered in the removal of these masses. CASE: We review the case of a 45-year-old woman who presented with massive abdominal swelling that was later identified as two distinct bilateral serous cystadenomas with a combined weight of approximately 107 kg. A multidisciplinary team including gynecology, plastic surgery, anesthesiology, and the operating room staff convened before surgery to discuss surgical technique, physiologic considerations, and logistical issues. CONCLUSION: A multidisciplinary approach had an integral role in intraoperative safety and successful recovery of our patient from this surgery.

Flow cytometric methods for prenatal and neonatal diagnosis.

Flow cytometry offers a promising alternative to the current methods of amniocentesis or chorionic villus sampling (CVS) for fetal cell sorting for prenatal diagnosis. While flow cytometric methods have been greatly improved to be more sensitive at detecting fetal cells within the maternal circulation, there are still several challenges that need to be overcome before application in prenatal diagnosis. However, flow cytometry is a powerful tool that can be used to enhance molecular testing and other diagnostic testing modalities in prenatal and neonatal diagnosis. It remains the gold standard to identify cellular immunodeficiencies and, for some immunological disorders with established biomarkers, flow cytometric assays can be used to make a definitive diagnosis. In this review, the advantages and disadvantages of using MACS and FACS analysis for fetal cell sorting are discussed. This review also includes an overview of the current flow cytometric assays and biomarkers that may be used for prenatal and neonatal diagnosis of common immunological and hematological abnormalities and the role of flow cytometry in treatment monitoring after bone marrow and stem cell transplantation.

Recommendations to improve preconception health and health care--United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care.

This report provides recommendations to improve both preconception health and care. The goal of these recommendations is to improve the health of women and couples, before conception of a first or subsequent pregnancy. Since the early 1990s, guidelines have recommended preconception care, and reviews of previous studies have assessed the evidence for interventions and documented the evidence for specific interventions. CDC has developed these recommendations based on a review of published research and the opinions of specialists from the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. The 10 recommendations in this report are based on preconception health care for the U.S. population and are aimed at achieving four goals to 1) improve the knowledge and attitudes and behaviors of men and women related to preconception health; 2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health; 3) reduce risks indicated by a previous adverse pregnancy outcome through interventions during the interconception period, which can prevent or minimize health problems for a mother and her future children; and 4) reduce the disparities in adverse pregnancy outcomes. The recommendations focus on changes in consumer knowledge, clinical practice, public health programs, health-care financing, and data and research activities. Each recommendation is accompanied by a series of specific action steps and, when implemented, can yield results within 2-5 years. Based on implementation of the recommendations, improvements in access to care, continuity of care, risk screening, appropriate delivery of interventions, and changes in health behaviors of men and women of childbearing age are expected to occur. The implementation of these recommendations will help achieve Healthy People 2010 objectives. The recommendations and action steps are a strategic plan that can be used by persons, communities, public health and clinical providers, and governments to improve the health of women, their children, and their families. Improving preconception health among the approximately 62 million women of childbearing age will require multistrategic, action-oriented initiatives.

Cloning and stem cells: processes, politics, and policy.

The creation of good science policy requires an understanding of the scientific technologic processes as well as an appreciation of the "politicization process" and contemporary politics. This article encompasses a review of nuclear transfer and stem cell technologies and advances against a backdrop of the politicization of science. The combination of these forces has rendered it almost impossible to develop true consensus on what any national policy regarding nuclear transfer should look like. Careful consideration of the multidimensional nature of these technologies and the myriad of social, economic, and cultural factors they will impact demands, however, that, at the very least, a national dialogue be instituted in an effort to frame good policy pertaining to nuclear transfer and stem cell research.