Pregnancy, cardiovascular health, and microchimerism.

PURPOSE OF REVIEW: To provide an updated review of scientific literature concerning associations between pregnancy and cardiovascular health among women, and to discuss a possible impact of microchimerism on the association. RECENT FINDINGS: In most studies, pregnancy and childbirth is associated with increased risk of cardiovascular disease in women. Some ascribe the association mainly to lifestyle, whereas others suggest that pregnancy itself negatively affects women's cardiovascular health. Pregnancy is a natural source of microchimerism, which in turn markedly affects female health. The only study published in the area surprisingly shows that among middle-aged women, male-origin microchimerism (MOM) is associated with half the risk of developing ischemic heart disease (IHD). No similar association is found between MOM and ischemic stroke. SUMMARY: The sparse evidence published suggests reduced risk of developing IHD among MOM-positive women. Despite the association being biologically plausible, replication of the findings is warranted to support that this is not a chance finding.

Medical students' perspectives on the ethics of clinical reality.

INTRODUCTION: Medical ethicists have pointed out that a gap exists between classroom teaching of bioethical theory and the ethics of clinical reality. Studies recommend that the teaching of bioethics should focus on everyday dilemmas in the clinical setting instead of only dramatic dilemmas and have expressed the need for more studies of how medical students perceive ethical problems in the clinical setting. This study explored themes in and types of ethical dilemmas in medical students' reflective writing in their clinical rotations. METHODS: The study was a qualitative explorative analysis of group reflection texts from fourth-year medical students at Aarhus University, Denmark. RESULTS: The thematic analysis of 51 group reflection texts (n = 396) revealed four key themes in the material: 1) confidentiality issues, 2) treatment options and side effects, 3) the students' role and responsibility and 4) information-giving and communication. The majority of the ethical dilemmas that the students identified were everyday dilemmas. Dramatic dilemmas were represented to a limited degree. CONCLUSIONS: Students' perspectives on ethical dilemmas in the clinical setting provide a unique opportunity to integrate a variety of ethical dimensions into bioethical education and draw attention to overlooked everyday ethical dilemmas. Thus, involving the students' perspectives may be a way to bridge the gap between bioethical theory and the ethics of clinical reality. FUNDING: none. TRIAL REGISTRATION: not relevant.