The Ethics of Abortion

In recent news, women of Northern Ireland are now able to get free abortions on the NHS in Britain. At present, in Northern Ireland, abortions are only allowed if the mother’s life is in danger or if there is a serious risk to her mental or physical health. Hundreds of women are forced to travel from Northern Ireland to England in order to get an abortion, this is costly and can be incredibly difficult for women.

In many religions and cultures, people believe that abortions should not be allowed unless there are extreme circumstances, for example, if a woman has been raped. Many believe that abortions result in an unlawful killing of a person and can be compared to murder. However, with current laws, in the UK abortions can be carried out until 24 weeks, but in some circumstances, it can be carried out later.

In the UK we are incredibly fortunate to have abortions available on the NHS, in countries like America many women are forced to carry out abortions by themselves at home or at a reduced price locally, but this is very dangerous.

At present, there is no scientific consensus as to when life begins so one can not truly say that women who want an abortion are killing or endangering a child as there is still a debate as to when life begins. Many pro-life advocates believe that life starts at fertilization, others believe it starts when limbs appear or when a major organ system assimilates.

However, the rights of the mother should not be put under the rights of an unborn fetus, The woman is alive and well and we should not undermine her rights and ability to make decisions by putting a zygote in front of her life and decisions. In addition, should we really bring a child into an overpopulated world and one in which its mother was forced to conceive it? Human rights violations in terms of the fetus are dependent on the age of the fetus, below 24 weeks the rights of the mother should be prioritized. However as the mother comes closer to full term, we must consider the human rights violations brought about by the death of a fetus.

Many pro-life supporters believe that abortion is a form of infanticide, which is the unlawful killing of children. Many countries are rife with female infanticide which is gender-based killing, People often kill female babies as traditionally, women were forced to live with their husband’s parents leaving their own parents without someone to care for them. This problem is especially prevalent in China after the one-child policy, which prompted many to kill and abandon female babies in order to try to conceive a male. In some countries, males are also more desired in rural areas as they are seen to be better workers. Abortions on the basis of sex are not lawful and in most cases, the sex of the child cannot be found before 24 weeks.

References:

http://www.bbc.co.uk/ethics/abortion

http://ethics.sandiego.edu/presentations/AppliedEthics/Abortion/abortion.pdf

http://www.bbc.co.uk/news/uk-politics-40438390

http://www.prochoiceactionnetwork-canada.org/abortioninfo/misconce.shtml

http://www.csus.edu/indiv/g/gaskilld/ethics/abortion.htm

 

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Invasive Lobular Carcinoma

Invasive Lobular Carcinoma is the second most common type of breast cancer and accounts for 8% to 14% of breast cancers, after Invasive Ductal Carcinoma. Carcinoma describes cancer occuring in the epithelial or lining layer of cells, almost all cases of breast cancer are carcinomas. The carcinoma can either be in the milk ducts or in the lobules and in some cases can be in both areas. ILC is characterised by small rounded cells that be difficult to find on mammograms as they do not readily form masses.

In this case, cancer has spread to surrounding tissues after being generated in the milk-producing lobules of the breast. It is invasive as it invades other parts of the breast. Over time, ILC can spread to the axillary lymph nodes, most commonly those situated under the armpits.

It is most common in women between the ages of 45 to 55, however, women outside of this range can develop ILC in some cases.

Symptoms include:

  • an area of thickening or swelling
  • a change in the nipple, for example if it turns inwards (inverted)
  • a change in the skin, such as dimpling or thickening

 

IF YOU EXPERIENCE ANY OF THESE SYMPTOMS OR OTHERS ASSOCIATED WITH BREAST CANCER, SEE YOUR DOCTOR IMMEDIATELY.

Mammograms, which are x-rays of the breasts, are usually used to diagnose breast cancer. Additionally, you could have a biopsy or an MRI scan, this is dependent on your physician.

In some cases a lumpectomy may be carried out, which is where the tumour/mass is removed without deconstruction of the breast. In some cases, a mastectomy is advised, especially if the tumours are relatively large. Many women also have their lymph nodes removed as a precaution or if the cancer has spread.

After surgery, radiotherapy, chemotherapy, biological therapy and hormone therapy may be used to treat cancer and can be a preventative measure. For some women, a hormone imbalance can cause uncontrolled growth of cancer cells so hormone therapy using oestrogen is used to reduce risk of recurrence.

Some breast cancers contain HER2/neu which is a growth-promoting protein that can cause the cancer to spread more quickly. Drugs that target the HER2 protein include Herceptin, a type of monoclonal antibody (antibody produced from a single clone of B cells), Tykerb, Perjeta and Kadcyla.

Testing of the sample can be done using immunohistochemistry (using antibodies that stick to the HER2 protein causing cells affected to change colour) and fluorescent in situ hybridisation (fluorescent DNA pieces stick to the HER2 gene, cells affected can be counted under a microscope).

References and Additional Information:

http://www.breastcancer.org/symptoms/types/ilc/subtypes

http://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/invasive_lobular_carcinoma.html

https://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr767

https://www.cancer.org/treatment/understanding-your-diagnosis/tests/understanding-your-pathology-report/breast-pathology/breast-cancer-pathology.html

http://www.cancerresearchuk.org/about-cancer/breast-cancer/stages-types-grades/types/invasive-lobular-breast-cancer

Multiple Sclerosis

Multiple Sclerosis is a life long condition that affects the brain and spinal cord. It usually diagnosed in people who are in their 20s and 30s.

It is an autoimmune condition, the immune system attacks the brain or spinal cord. In MS the immune system attacks the myelin sheath, a protective coating, around nerve cells. This results in messages transmitted along these nerves being disrupted, slowed and weakened.

Symptoms include:

  • Fatigue
  • Numbness
  • Balance and co-ordination problems
  • Muscle stiffness and spasms
  • Cognitive difficulties
  • Difficulty walking
  • Problems with vision

MS can occur in two ways:

  1. Relapsing-remitting MS

This occurs when symptoms progressively worsen in the span of a few days. The attacks may occur every few years. Although around half of the people with MS of this sort do go on to develop the second type within the next 15-20 years.

2. Primary progressive MS

In this type of MS there are no periods of remission, but instead symptoms progressively worsen.

Treatments include using steroids to treat relapses. Disease-modifying therapies can be used to reduce the frequency of relapses as well as specific treatments focused on alleviating symptoms.  At present, there is no cure for either type of MS and it will progressively get worse. However research is leading to strides in the development of new medication.

 

References:

https://www.nice.org.uk/guidance/cg186

http://www.nhs.uk/conditions/Multiple-sclerosis/Pages/Introduction.aspx

https://www.mssociety.org.uk/what-is-ms

http://www.ms-uk.org/whatisms

Trigeminal Neuralgia

The trigeminal nerve or fifth cranial nerve is the nerve that sends pain impulses to the brain. When the nerve malfunctions, impulses can be sent at the wrong time, when there is no real pain. However, the sufferer will still feel sharp pain of great intensity. It usually occurs when the protective coating around the trigeminal nerve, the myelin sheath is damaged. High blood pressure, tumours and multiple sclerosis can cause this damage. Rarely, a tangle of arteries and veins called an arteriovenous malformation can also lead to the attack. The attacks can span from a few seconds or to a few minutes, the pain is often unbearable It often only affects one side of the face, usually the right hand side.

The attacks are often brought about by light touching of the face, this can be due to light intensity, wind, air conditioning, eating, washing and even breathing. This means that it is incredibly difficult to control. It usually occurs in those who are over 40 and is more frequent in women than in men.

Treatment can vary but usually:

  1. Anticonvulsant Drugs

Carbamazepine is often used in treatment in order to prevent nerve firing. It slows down nerve impulses, reducing the ability to transmit pain messages. It has to be taken in large doses in order to be effective.

2.  Surgery

Surgery such as nerve replacement therapy can be used in treatment. Through cutting part of the nerve, numbness occurs and the pain is dulled or ceases. However, the nerve may regrow which results in further pain and the need for more surgery and medications.

The National Institute of Neurological Disorders and Stroke (NINDS) is researching the disease. Mice can be used to understand the relationship between the nervous system and the vascular system. Researchers are looking at the role estrogens may play in affecting nerve pain activity, due to the disease being more prevalent in women compared to men.

 

References:

https://www.tna.org.uk/pages/condition.html

https://www.tna.org.uk/pages/condition.html

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet#3236_1

The Liver

The liver is the second largest organ in the body and is responsible for:

  • Detoxification of poisonous substances like alcohol.
  • Producing bile that is used in lipid digestion.
  • Controlling cholesterol levels by breaking down cholesterol through use of HDL’s.
  • Aiding blood clotting.
  • Fighting infections.

Types of liver diseases:

  1. Alcohol-related

Alcohol consumption can lead to a build up of fats within the liver. Fatty liver disease is reversible, if alcohol consumption is reduced drastically for around a month. Alcoholic hepatitis can occur after substance abuse with alcohol and binge drinking. Cirrhosis can also occur when the liver has been scarred. A liver transplant is only required, usually, in the late stages of cirrhosis. However usual treatment is to reduce alcohol consumption drastically after diagnosis and maintaining a balanced life style.

2. Non-alcoholic fatty liver disease.

This usually occurs in people who are overweight or obese and leads to a build up of fat within the liver. This can lead to fibrosis which causes persistent inflammation that leads to  scar tissue around the liver and nearby blood vessels. This can then later turn into cirrhosis.

3. Hepatitis

This is inflammation of the liver due to a viral infection or damage caused by alcohol. Symptoms include joint pain, high temperature, feeling sick, jaundice and itchy skin to name a few. Types of hepatitis:

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatitis D
  • Hepatitis E
  • Alcoholic hepatitis
  • Autoimmune hepatitis

4. Haemochromatosis

This is an inherited condition that is due to a slow build up of iron in the body. Symptoms include: weight loss, joint pain, fatigue, weakness etc. Treatments include: phlebotomy: removal of blood to stabilise iron levels and chelation therapy: medication to reduce iron levels. Haemochromatosis is caused by a faulty gene that affects how the body absorbs iron from food.

5. Primary biliary cirrhosis

This occurs when the bile ducts in the liver become damaged. This leads to a build up of bile in the liver that leads to cirrhosis, scarring. The immune system attacks bile ducts, this scars bile ducts making it difficult for bile to move out of the liver. It is a progressive condition that worsens over time.

Liver disease can usually be treated in a variety if ways, but in the worst cases a transplant may be required.

References:

http://www.nhs.uk/conditions/liver-disease/Pages/Introduction.aspx

http://www.medicinenet.com/liver_disease/page3.htm

http://www.nhs.uk/conditions/Liver_disease_(alcoholic)/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/fatty-liver-disease/Pages/Introduction.aspx

http://www.nhs.uk/conditions/Hepatitis/Pages/Introduction.aspx

http://www.webmd.boots.com/a-to-z-guides/digestive-diseases-hepatitis

https://www.britishlivertrust.org.uk/liver-information/liver-conditions/hepatitis-c/

http://www.nhs.uk/conditions/Haemochromatosis/Pages/Introduction.aspx

https://www.britishlivertrust.org.uk/liver-information/liver-conditions/haemochromatosis/

http://haemochromatosis.org.uk/

http://www.nhs.uk/conditions/Primary-biliary-cirrhosis/Pages/Introduction.aspx

http://www.mayoclinic.org/diseases-conditions/primary-biliary-cirrhosis/basics/definition/con-20029377

https://www.britishlivertrust.org.uk/liver-information/liver-conditions/primary-biliary-cirrhosis/

 

Shock

Shock is a life threatening condition that occurs when blood flow is restricted. This means that the cells don’t get enough oxygen to enable them to work properly, which can lead to damage of the vital organs like the brain and the heart. Cells require oxygen and glucose so when deprived of blood, the tissues begin to die.

Recognition:

  • Rapid pulse.
  • Pale, cold, clammy skin.
  • Sweating.

As shock develops symptoms change:

  • Rapid, shallow breathing.
  • Weak, thready pulse.
  • Grey-blue skin, especially inside lips.
  • Weakness
  • Giddiness
  • Nausea
  • Vomiting
  • Thirst

As the brain’s oxygen supply weakens:

  • Restlessness and aggressive behaviour.
  • Gasping for air.
  • Loss of consciousness.

Shock can be caused by any condition that reduces blood flow, including:

  • Heart problems (such as heart attack or heart failure)
  • Low blood volume (as with heavy bleeding or dehydration)
  • Changes in blood vessels (as with infection or severe allergic reactions)
  • Certain medicines that significantly reduce heart function or blood pressure

Treatment:

In first aid, you would have to help the casualty lie down and then raise and support the legs over the level of the casualties heart.

References

http://www.sja.org.uk/sja/first-aid-advice/heart/shock.aspx

https://medlineplus.gov/ency/article/000039.htm

http://www.emedicinehealth.com/shock/article_em.htm

The Heart and Associated Problems

The heart is an organ that is responsible for pumping blood around the body, to all of the tissues. In humans, there is a double circulatory system which means that the blood returns to the heart after passing to the lungs to be oxygenated so that it can be sent to the rest of the body, this is to ensure that there is enough blood pressure to pump blood to all of the tissues and organs. Problems begin to arise when the heart becomes damaged or the vessels it is associated with become damaged. This can arise in a number of different ways.

  1. Atheroma

This occurs when fatty deposits build up within arterial walls. White blood cells that have taken up low density lipoproteins result in fatty streaks within the walls, these streaks build up over time. When the streaks enlarge over a long period of time they form what is known as an atheromatous plaque. The deposits push into the lumen, causing it to narrow, reducing blood flow. Atheromas increase the risk of thrombosis and aneurysm.

2. Thrombosis

When an atheroma breaks through the endothelium lining it increases friction at the surface of the lumen which can result in a blood clot, a thrombus. This reduces blood supply, leading to tissue on the other side of the clot being deprived of oxygen, glucose and other nutrients essential for its survival and as a result the tissue dies.

3. Aneurysm

Atheromas weaken arterial walls, the weaker points lead to a balloon like, blood filled structure known as an aneurysm. Aneurysms burst frequently, leading to haemorrhage and lead to a loss of blood to the region of the body served by that artery.

4. Myocardial Infarction

This is known as a heart attack, this results in a reduced supply of oxygen to the heart. This can lead to the heart stopping beating as its blood supply is completely cut off. The heart stops beating as it is at risk of dying. It is caused by thrombosis and atheromas.

References:

https://patient.info/health/atheroma

http://www.thrombosisuk.org/home.php

http://www.medicalnewstoday.com/articles/156993.php

http://emedicine.medscape.com/article/155919-overview