The pill of choice?

Article Abstract:

Anew pill that achieves abortion without surgery, RU 486, is having a great impact on the moral, political and medical aspects of the abortion debate. RU 486 appears to be an extremely safe and effective method of terminating pregnancy during the first nine weeks of gestation. Anti-abortion protestors have succeeded in preventing its introduction in the US and have thwarted research efforts into its possible uses. Developed in France by Etienne-Emile Baulieu of the company Roussel-Uclaf, it is generally available only in that country. The manufacturer, a subsidiary of the German firm Hoechst AG, attempted to cease distribution of the drug after only one month, in the fall of 1988, possibly due to threats to boycott all Hoechst products if distribution continued, but was pressured by the French government into continuing to supply the abortion pill that was now the "moral property of women". Since Oct 1988, 150 to 200 French women have been treated with RU 486 daily, representing 25 to 33 percent of all abortions in France. The process requires the patient to take three pills of RU 486, with a follow-up dose of prostaglandin 48 hours later. The embryo can no longer be sustained and the uterus contracts to expel the tissues, with 96 percent effectiveness. Minor side-effects similar to heavy menstruation are reported, with one case in 1,000 needing a blood transfusion. The drug offers the privacy of treatment in a doctor's office rather than an abortion clinic. It could also save countless lives in developing countries where nearly 50 percent of maternal deaths result from unsafe abortions. Should the US Supreme Court increase limitations on surgical abortions, RU 486 may become a major focus of pro-choice groups. Approval from the US Food and Drug Administration would take an estimated three years after a decision to manufacture. Illegal markets for RU 486 may develop outside France and this could have severe medical consequences if the drug is misused. Some experts believe that this revolutionary drug will reach the market in any event, since it is too significant to be stopped.

Methods, Political aspects, Abortion, Abortion services, Mifepristone, editorial

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The sobering geography of AIDS

Article Abstract:

Data from the World Health Organization show that 340,000 cases of AIDS have been reported so far worldwide. However, it is known that certain developing countries report only 5 to 10 percent of the actual number of cases, bringing the estimated number of cases to 1,000,000. It is estimated that another 8 to 10 million individuals are infected with the human immunodeficiency virus (HIV), which will, in time, develop into AIDS. The epidemic of AIDS in parts of Africa is well known, with an estimated 6 million adults and 500,000 infants having AIDS. The estimated infection rate by the year 2015 in urban areas of Africa is nearly 16 percent. Epidemics are also expected to develop in areas of Asia and Latin America, with the epidemic in India projected to be much greater than the one in Africa. The numbers of cases of AIDS in India, Thailand and South China are small, but the numbers of individuals who are thought to be infected with HIV are very large, approximately 500,000. Other estimates of numbers of infected individuals are even higher. These countries also have high rates of sexually transmitted diseases, which can increase the spread of infection with HIV. In Latin America and the Caribbean, the estimated number of people infected with the virus is approximately 1 million. The rate of infection in North America has slowed, especially in some sub-populations, such as homosexual men. It is felt that education and prevention methods designed to change high-risk behavior will not be effective worldwide and that a vaccine is desperately needed. Others think that behavioral changes will slow the spread of AIDS. How these changes will affect the rate of disease spread is not clear. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Reports, Demographic aspects, India, Africa, World Health Organization, Caribbean Islands, Caribbean Area

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Shooting at a new HIV target

Article Abstract:

Two teams of researchers, one at Smith Kline and French Laboratories, the other at Upjohn Company, have discovered compounds which prevent the AIDS virus, HIV, from reproducing itself. The compounds work by interfering with a protein-degrading enzyme which the virus requires to reproduce. This enzyme, called an aspartic proteinase, resembles the human enzyme renin, which gave researchers a head start in understanding its structure and function and in developing compounds to block it. In tissue culture, HIV-infected cells continue to produce virus in the presence of the enzyme inhibitors, but the new virus is incapable of reproduction. The enzyme inhibitors have not yet been tested in patients; the step to patients is a large one. Proteinases are common in the body, and if it turns out that the HIV-protease inhibitor also inhibits an enzyme required for normal body processes, the treatment might be as bad as the disease. Researchers point out that even though taking a tissue culture phenomenon and turning it into a drug is a difficult step to take, it is a necessary one in the development of new anti-HIV drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Prevention, HIV (Viruses), HIV, AIDS research, Virus replication

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