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Appeals Court Panel Says Pharmacists Must Distribute Emergency Contraception Under Washington State Regulation
A three-judge panel of the U.S. Circuit Court of Appeals for the 9th Circuit on Wednesday unanimously ruled to lift an injunction blocking Washington state officials from penalizing pharmacists who refused to dispense the emergency contraception pill Plan B, the Los Angeles Times reports (Williams, Los Angeles Times, 7/9). The panel said the district court judge who issued the injunction refused to consider women"s need for EC (Egelko, San Francisco Chronicle, 7/9). The panel"s ruling is part of a larger case before the district court involving the constitutionality of a 2007 state regulation requiring pharmacies to stock and dispense EC. Joyce Roper, an assistant attorney general for Washington state, said the appeals court ruling means that the 2007 regulation will take immediate effect.The plaintiffs in the case, Stromans -- a supermarket pharmacy owner -- and two pharmacists employed elsewhere, argued that the state regulation requiring pharmacists to stock and dispense EC violated their First Amendment right to freedom of religion (Los Angeles Times, 7/9). The regulation said that pharmacies must stock and fill legally prescribed prescriptions but allowed individual pharmacists to object on moral or religious grounds if another pharmacist was available, in person or by telephone, to fill the order (San Francisco Chronicle, 7/9). The plaintiffs argued that the regulation would force them to choose between following their religious beliefs and keeping their jobs. They contended that EC prevents implantation of a fertilized egg, which they equated with abortion. The U.S. District Court in Seattle awarded the plaintiffs the temporary injunction in November 2007, pending trial on the constitutionality of the regulation (Los Angeles Times, 7/9). Plan B contains a high dose of a drug found in most birth control pills that generally prevents ovulation or the fertilization of an egg. Recent research suggests that it does not prevent a fertilized egg from implanting in the uterus (Woodward, AP/Seattle Post-Intelligencer, 7/8). FDA in April lowered the age limit for nonprescription purchase of Plan B from 18 to 17 (San Francisco Chronicle, 7/9). Appeals Panel Returns Case to District CourtThe appeals court panel ruled that the freedom to exercise one"s religion "does not relieve an individual of the obligation to comply with a valid and neutral law of general applicability." The panel added, "Any refusal to dispense -- regardless of whether it is motivated by religion, morals, conscience, ethics, discriminatory prejudices or personal distaste for a patient -- violates the rules" (Los Angeles Times, 7/9). The panel ordered the district judge to reconsider the 2007 regulation under Supreme Court standards that allow states to pass neutral laws that may affect religious practices. According to the panel, the regulation does not aim to interfere with religious practices or beliefs and is intended to promote patients" health. In addition, the panel said the district court judge did not consider how the injunction would affect "sexually active women of childbearing age who will be denied reasonable access to Plan B" (San Francisco Chronicle, 7/9). According to the Times, the panel"s ruling could foretell future judgments in the case, including that a patient"s right to timely medication surpasses a pharmacist"s personal beliefs (Los Angeles Times, 7/9).
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Intestinal Cells Surprisingly Active In Pursuit Of Nutrition And Defense
Every cell lining the small intestine bristles with thousands of tightly packed microvilli that project into the gut lumen, forming a brush border that absorbs nutrients and protects the body from intestinal bacteria. In the June 29, 2009 issue of the Journal of Cell Biology, Matthew McConnell, Matthew Tyska, and colleagues now find that microvilli extend their functional reach even further using a molecular motor to send vesicles packed with gut enzymes out into the lumen to get a head start on breaking down their substrates.
News of the day
Japanese Rock Pool Mosquitoes Become Established In Minnesota, USA
Faced with a new mosquito species that could transmit disease in Minnesota, state health and mosquito control officials are urging residents to rid their property of water-holding containers. The Minnesota Department of Health (MDH) and the Metropolitan Mosquito Control District (MMCD) confirmed that the Japanese rock pool mosquito (Aedes japonicus) is established in at least five southeastern Minnesota counties. This mosquito could potentially transmit LaCrosse encephalitis virus (LAC) and West Nile virus (WNV) to humans.
Public Health

Video Games Are Helping Doctors View The Body - Using The Nintendo Wii To Interpret Radiology Exams

The popular Nintendo Wii videogame system is helping radiology students reach new levels! Faculty from Weill Cornell Medical College have coupled the motion-sensitive Wii remote with the same computers used to analyze scans, and have found that the Wii remote makes examining CT and MRI images more ergonomic, heightens the interactivity during classes, and may potentially improve the ability to interpret scans. "The remote is very intuitive -- cycling through the scans is a matter of rotating your wrist," explains Dr. George Shih, a radiologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of radiology at Weill Cornell Medical College, who, along with his colleagues, helped develop the system that links the Wii remote to the diagnostic computer. Their research was presented recently at the 2009 American Roentgen Ray Society (ARRS) Annual Meeting in Boston, Mass. Traditionally, radiologists might spend hours at a time, with only short breaks, reading scans using a typical mouse and keyboard. Many of the movements are repetitive and require precise mouse-clicking and scrolling, which can be taxing on the body and may lead to repetitive motion injuries such as carpal tunnel syndrome. "The easiest way to avoid injury is to change positions," says Dr. Shih, and that is exactly what using the Wii remote allows. By simply holding the remote in their hand and rotating their wrist, radiologists can gradually inspect the scans, while sitting in any position they find most comfortable. Dr. Shih demonstrated that a person using the remote could sit back and relax in his seat, with his arms draped to the sides, and still maintain the same ability to interpret scans as compared to rigidly sitting at a desk using a mouse and keyboard. Within the remote lies a device that measures 3-D motion, called an accelerometer, which allows the user to advance through the scan with simple movements. "We are not currently using the Wii remote in actual clinical diagnosis," says Dr. Shih, "but we"re hoping to show that it can become an alternative that is at least as accurate as using a traditional keyboard and mouse." Currently, the Wii is being used in radiology courses at Weill Cornell as a tool for teaching students. Since the Wii remote is wireless, with a wide range, instructors can hand the controller to students sitting in the lecture hall to scan images themselves. He says this boosts the class" interactivity, allowing the students to interpret scans rather than simply observe the instructor. "It"s exciting to see faculty members creating innovative tools to push the boundaries of not only education, but also technology that has the potential to change the entire field of radiology," says Dr. Robert Min, radiologist-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and the chairman of radiology at Weill Cornell Medical College. To create the device, Dr. Shih collaborated with a longtime friend and colleague Dr. Michael Brown, and with Lu Zheng from School of Computing at the National University of Singapore. Drs. Matthew Amans and Cliff Yeh, radiology residents at Weill Cornell, were also involved in the development and design of the system. Weill Cornell Medical College


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