GENERALMEDICALLITERATURE
We in this section offer commentaries on a broad survey of recent articles in the English literature. Articles are mostly chosen for two reasons: their potential translational value for immediate clinical practice or to help in determining where clinical practice might evolve to. Today’s subjects are of general medical interest.
And Private equity in healthcare continues to get attacked
In all of the Center for Human Reproduction (CHR) publications, The Reproductive Times and The
VOICE, we have continuously covered how private equity has interacted and invaded the healthcare
world. What sparked this addition in our coverage was a recent article in The Wall Street Journal,
therefore, unsurprisingly attracted our attention when it described a recent bipartisan Senate report as “blasting” the role of Private Equity in health care (1). The report, indeed, went so far as to state that these kinds of investments are putting the whole medical system in the U.S. at risk.
Our antipathy to Private Equity, of course, to a large degree stems from its heavy involvement in the infertility field, but that is a separate subject, to be addressed elsewhere.
Reference
1. Cumming C. The Wall Street Journal. January 8, 2025. https://www.wsj.com/articles/senate-report-blasts-private-equitys-role-in-healthcare-b77d711f
A new vision for evolution?
We saw this question raised in a book review in Nature magazine (1) and found it interesting enough to bring it here to our readers’ attention. The modern synthesis of evolution is still the current textbook evolutionary theory, widely considered an absolute dogma. Now the author of the book review is telling us that new thinking on the subject is overdue, as offered by four eminent evolutionary biologists in a recently published book, “Evolution Evolving” (2).
The dogma of “modern synthesis” claims that evolutionary adaptations exclusively occur through gradual and natural selection of DNA mutations which arise at random. The five authors of this book have for considerable since approximately 2015 been proposing as an alternative—the so-called “extended modern synthesis” —that how and/or where an organism develops also plays an important role. In other words, evolution is not only a process of natural DNA selection but also in what environment this selection occurs (3).
And the debate is hotly contested.
Examples for the importance of the environment abound: Take for example the Mexican tetra fish, of which some populations (A. mexicanus) are blind cave fish living in darkness. Other populations of the same fish exist as surface dwellers and have full vision. When those surface dwellers, however, are kept in full darkness for two years, they develop traits that mimic the blind cave fish. So, which of the two theories is correct? To us it seems that both are correct, not different to the principles of epigenetics: The basis is the DNA; but then comes the environment into play, determining how this DNA functions.
References
1. Jablonka E. Nature 2025;637:539-541
2. Kevin Lala et al., Evolution Evolving: The Developmental Origins of Adaptation and Biodiversity. Viking Books, 2024.
3. Lala et al., Proc R Soc B2015;B282.20151019
A word about stem cell donations
Far beyond just the medical literature, so-called stem cell donations have, indisputably, become one of the “hottest” subjects in medicine. They, indeed, also have become one of the most “abused” subjects, likely best demonstrated by all the “stem cell clinics” that, often to the chagrin of the FDA, have opened in the U.S. and across the border in Mexico, which offer alleged treatments and cures for practically almost any malady. And reproductive medicine is, of course, no exception. Information of “real” stem cell treatments, therefore, always are welcome and this is exactly what a brief recent article in JAMA is offering regarding allogeneic (from another individual obtained) stem cell donation entails (1). This article not only appears timely but in a way also informs on the difference between “real” and “fake” stem cell therapies. Just one example: If you get your own fat-cells injected, those are “autologous” (your own) and not “allogeneic.” Moreover, just because you get your fat cells injected, does not mean that among the few cells injected are real stem cells.
Reference
1. Amonoo et al., JAMA 2025;333(1):81-82