Animal Protection and Medical Science

Over the past decade, the debate concerning animal use in biomedical research, education, and testing has contributed to an environment of public posturing on both sides. Many in the medical and animalprotection communities have come to view one another as adversaries with hopelessly different goals. In the face of rapid and substantial increases in public concern over the wellbeing of animals, many in the medical community have sought to fend off what they see as an increasingly threatening social trend. Those who have spoken out on behalf of various medical organisations or institutions have generally been avid animal-research advocates. Those with dissenting viewpoints within the medical community have been labelled dangerous and have been discouraged from advancing their opinions publicly— developments contrary to the spirit of science. Faced with this one-sided argument the broader medical community has failed to call attention to various untenable positions of many animal-research advocates, who have sought exclusive representation of medical science in this debate. Uncritical acceptance of these positions could substantially damage the credibility of medical science, fuel the fires of those seeking to characterise physicians as self-serving, self-righteous individuals who value their scientific careers above all else, and ultimately lead the public to withdraw control of this aspect of medical science from physicians

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Mirror aneurysms:a reflection on natural history

OBJECT: Investigators conducting the International Study of Unruptured Intracranial Aneurysms, sponsored by the National Institutes of Health, sought to evaluate predictors of future hemorrhage in patients who had unruptured mirror aneurysms. These paired aneurysms in bilateral arterial positions mirror each other; their natural history is unknown. METHODS: Centers in the US, Canada, and Europe enrolled patients for prospective assessment of unruptured intracranial aneurysms. Central radiological review confirmed the presence or absence of mirror aneurysms in patients without a history of prior subarachnoid hemorrhage (SAH) (Group 1). Outcome at 1 and 5 years and aneurysm characteristics are compared. RESULTS: Of 3120 patients with aneurysms treated in 61 centers, 376 (12%) had mirror aneurysms, which are more common in women than men (82% [n = 308] vs 73% [n = 1992], respectively; p <0.001) and in patients with a family history of aneurysm or SAH (p <0.001). Compared with patients with nonmirror saccular aneurysms, a greater percentage of patients with mirror aneurysms had larger (>10 mm) aneurysms (mean maximum diameter 11.7 vs 10.4 mm, respectively; p <0.001). The most common distribution for mirror aneurysms was the middle cerebral artery (34% [126 patients]) followed by noncavernous internal carotid artery (32% [121]), posterior communicating artery (16% [60]), cavernous internal carotid artery (13% [48]), anterior cerebral artery/anterior communicating artery (3% [13]), and vertebrobasilar circulation (2% [8]). When these patients were compared with patients without mirror aneurysms, no statistically significant differences were found in age (mean age 54 years in both groups), blood pressure, smoking history, or cardiac disease. Aneurysm rupture rates were similar (3.0% for patients with mirror aneurysms vs 2.8% for those without). CONCLUSIONS: Overall, patients with mirror aneurysms were more likely to be women, to report a family history of aneurysmal SAH, and to have larger aneurysms. The presence of a mirror aneurysm was not an independent predictor of future SAHs