RESUMEN
The purpose of this article is to ascertain and appraise the ethical issues inherent to the utilisation of preimplantation genetic diagnosis for gender selection in infertile patients anticipating undergoing a medically indicated assisted reproductive technique procedure. Performance of preimplantation genetic diagnosis per request specifically for gender selection by an infertile couple undergoing medically indicated assisted reproductive technique may not breach the principles of ethics, and is unlikely to alter the population balance of sexes.
Asunto(s)
Diagnóstico Preimplantación/ética , Técnicas Reproductivas Asistidas , Preselección del Sexo/ética , Discusiones Bioéticas/legislación & jurisprudencia , Ética Médica , Composición Familiar , Femenino , Humanos , Recién Nacido , Infertilidad/terapia , Masculino , Embarazo , Diagnóstico Preimplantación/métodos , Ética Basada en PrincipiosRESUMEN
Premature ovarian failure due to Xp duplication and Xq deletion has been reported in four patients, the youngest of whom was 18 years old. The diagnosis has been made with new techniques for genetic analysis, such as comparative genomic hybridization and fluorescence in situ hybridization. We report the youngest case (a 12-year-old who presented with irregular menses), of premature ovarian failure due to Xp duplication and Xq deletion and the first with 46,X,der(X)t(X;X)(q22.1;p11). The diagnosis was made using C-banding and fluorescent in situ hybridization with locus-specific probes. This case highlights the need to use advanced genetic strategies to determine karyotypic and phenotypic abnormalities.
Asunto(s)
Insuficiencia Ovárica Primaria/genética , Niño , Cromosomas Humanos Par 11 , Cromosomas Humanos Par 22 , Cromosomas Humanos X , Femenino , Eliminación de Gen , Duplicación de Gen , Humanos , Hibridación Fluorescente in Situ/métodos , CariotipificaciónRESUMEN
Hemorrhage continues to be a serious complication of both obstetrical and gynecologic surgeries. Physicians have used packing in cases of uncontrollable hemorrhage for many years, and this article reports on a modification of standard packing techniques that prevents some of the limitations of traditional packing. This technique was used in 1 patient after cesarean hysterectomy and 3 patients after debulking surgery for advanced gynecologic cancer. The pack consists of a wide piece of ribbon gauze and a Penrose drain. One end of the ribbon gauze is draped over a layer of surgicel (oxidized regenerated cellulose), while the rest is threaded through a 1-inch Penrose drain tightly folded several times to maintain pressure over the bleeding area. The other end of the Penrose drain, with the ribbon gauze visible within it, is inserted through a stab incision in the ipsilateral side of the lower abdomen. This technique allows for continuous bleeding assessment and easy removal of the gauze at bedside.
