MRI Studies: The Brain Permanently Altered From Infant Circumcision

MRI Studies: The Brain Permanently Altered From Infant Circumcision
by Dr. Paul D. Tinari Ph.D.

Two of my physics professors at Queen's University (Dr. Stewart & Dr. McKee) were the original developers of Positron Emission Tomography (PET) for medical applications. They and a number of other Queen's physicists also worked on improving the accuracy of fMRI for observing metabolic activity within the human body.

As a graduate student working in the Dept. of Epidemiology, I was approached by a group of nurses who were attempting to organize a protest against male infant circumcision in Kinston General Hospital. They said that their observations indicated that babies undergoing the procedure were subjected to significant and inhumane levels of pain that subsequently adversely affected their behaviours. They said that they needed some scientific support for their position.

It was my idea to use fMRI and/or PET scanning to directly observe the effects of circumcision on the infant brain.The operator of the MRI machine in the hospital was a friend of mine and he agreed to allow us to use the machine for research after normal operational hours. We also found a nurse who was under intense pressure by her husband to have her newborn son circumcised and she was willing to have her son to be the subject of the study. Her goal was to provide scientific information that would eventually be used to ban male infant circumcision. Since no permission of the ethics committee was required to perform any routine male infant circumcision, we did not feel it was necessary to seek any permission to carry out this study.We tightly strapped an infant to a traditional plastic "circumrestraint" using Velcro restraints. We also completely immobilized the infant's head using standard surgical tape.

The entire apparatus was then introduced into the MRI chamber. Since no metal objects could be used because of the high magnetic fields, the doctor who performed the surgery used a plastic bell ("Plastibell") with a sterilized obsidian bade to cut the foreskin. No anaesthetic was used.The baby was kept in the machine for several minutes to generate baseline data of the normal metabolic activity in the brain. This was used to compare to the data gathered during and after the surgery.

Analysis of the MRI data indicated that the surgery subjected the infant to significant trauma. The greatest changes occurred in the limbic system concentrating in the amygdala and in the frontal and temporal lobes.A neurologist who saw the results to postulated that the data indicated that circumcision affected most intensely the portions of the victim's brain associated with reasoning, perception and emotions. Follow up tests on the infant one day, one week and one month after the surgery indicated that the child's brain never returned to its baseline configuration. In other words, the evidence generated by this research indicated that the brain of the circumcised infant was permanently changed by the surgery.

Our problems began when we attempted to publish our findings in the open medical literature. All of the participants in the research including myself were called before the hospital discipline committee and were severely reprimanded. We were told that while male circumcision was legal under all circumstances in Canada, any attempt to study the adverse effects of circumcision was strictly prohibited by the ethical regulations. Not only could we not publish the results of our research, but we also had to destroy all of our results. If we refused to comply, we were all threatened with immediate dismissal and legal action.I would encourage anyone with access to fMRI and /or PET scanning machines to repeat our research as described above, confirm our results, and then publish the results in the open literature.

Dr. Paul D. Tinari, Ph.D.Director,Pacific Institute for Advanced StudyMore on Circumcision and Neurological/Brain Impact Studies:Circumcision Pain Studies End Early Due to Infant TraumaInfant Pain Impacts Adult Sensitivity & Perception

Child dies in circumcision

SUN STAR, Dumaguete, Philippines Islands, Tuesday, August 5, 2008.

AN ELEVEN-year- old boy died in circumcision believed to be infected with tetanus.Lydia Amantillo, grandmother of the victim Gino Erojo, told Sun.Star that her grandson experienced high fever few hours after he was circumcised on July 24.

Erojo, a native of Panciao, Manjuyod, Negros Oriental and a grade 5 pupil of Lucay Elementary School, availed the free circumcision in a medical mission sponsored by Representative Jocelyn Limkaichong in the first congressional district of the province.

The victim's family blamed the "unsanitized" equipment causing the infection.

The child was rushed to Negros Oriental Provincial Hospital on July 31, but died around 9:45 p.m. Sunday.The child's family, although blaming the doctor, said they have no plans to sue anybody for the victim's death.

The family also said they do not blame the medical mission sponsored by the Limkaichong.

However, Amantillo said they appeal to the concerned persons to be extra careful in handling the process of circumcision.

They also asked Limkaichong and other government agencies to help them pay the hospital bills, embalming expenses and transport of the child's body from Dumaguete City to their home in Manjuyod town.

Manjuyod is more than 58 kilometers north of Dumaguete City. (VLC)

Anti-circumcision activists rally today to demand US ban circumcision

March 31, 3:36 PM

12 years ago today, the US passed a law banning female genital mutilation, also known as female circumcision. To mark the anniversary, protesters marched in Washington DC to protest that male circumcision is still legal.

These activists call themselves "intactivists", and are pushing for an end to public funding for circumcision. So far, 16 states, including Washington State, have banned Medicaid funding for the purposes of circumcision. According to the International Coalition for Genital Integrity, state governments can save $1 million a year by cutting public funding for circumcision.

Circumcision is an increasingly controversial topic in the US. In 2006, 56% of male infants were circumcised in the US, meaning the foreskin is removed from the penis in an elective surgery, usually performed in the first 24 hours of life. This rate has been going down in the US. Outside the US, circumcision is not routinely practiced in any other Western industrialized country.

Circumcision is not a medically necessary procedure, and is usually performed because of religious reasons or out of family tradition. The American Academy of Pediatrics does not recommend the procedure, even taking into consideration potential health benefits. Recent research suggesting that circumcision helps protect against HIV has been contradicted by other research, adding to the confusion for parents making decisions about circumcision.

For many parents, however, it is remains an important procedure. The debate is highly charged, not surprising for a very intimate and personal issue. According to Brian J. Morris, a professor of molecular medical sciences in Australia, anti-circumcision activists "are just ignorant do-gooders with a misplaced sence of political correctness, who get sucked into these organizations by believing the rubbish posted on their websites." On the other side, Van Lewis, an "intactivist" told the Washington Post, "We're living in denial as a nation. Of what we've done to ourselves."

Ultimately, the decision on whether to circumcise a child is one parents must make with their doctors and families. It is just the beginning of many difficult choices parents will make over the course of their child's lifetime.
source: http://www.examiner.com/x-1146-Seattle-Eastside-Parenting-Examiners~y2009m3d31-Anticircumcision-activists-rally-today-to-demand-US-ban-circumcision

Adoption of male circumcision to fight HIV dangerous and unethical

A South African human rights group urges government to halt male circumcision adoption, calling the plan dangerous and unethical.

"The promotion of male circumcision is sending the wrong message, creating a sense of false protection, and placing women at greater risk for HIV. Males are already lining up to be circumcised so that they no longer need to wear condoms (v). Women may be the most harmed by the promotion of male circumcision (vi)," says Dean Ferris, director of the National Organisation Information resource Centres - South Africa (NOCIRC-SA).

New studies released since the three randomized control trials (RCTs) on HIV and circumcision show that RCT results cannot be applied to the general population of Sub-Saharan Africa or anywhere else (i).

Two studies published in 2008 concluded that male circumcision is not associated with reduced HIV infection rates in the general sub-Saharan population. The study specifically analysing circumcision rates and HIV in South Africa found that, "Circumcision had no protective effect on HIV transmission (ii).

"Infection rates between both groups leveled off at the end of all the RCTs and circumcision may only delay HIV infection, but does not affect overall rates.

In South Africa, the Zulus do not practice circumcision, while the Xhosas do practice circumcision. The HIV rates of each group are statistically the same.

"Especially troubling is the extraordinarily high rate of complications from male circumcision in Africa. A 2008 WHO bulletin reported an alarming 35% complication rate for traditional circumcisions and an 18% complication rate for clinical circumcisions (iii).

African's overburdened health care system cannot handle the tens of thousands of circumcision complications that would result from mass circumcision campaigns," Ferris contends, "A 2008 study found that increased use of condom promotion would be 95 times more cost effective than male circumcision in preventing new HIV infections (iv).

"Ferris goes on to say, " Studies have shown that the removal of the foreskin results in a less sensitive penis (ix). A less sensitive penis coupled with the reduced sensitivity afforded by condoms, may encourage males not to use them (x). It is unethical for circumcisions to be carried out on adult males unless fully informed consent has been obtained. The number of reports of African males agreeing to circumcision so that they no longer need to use condoms reveals that they are consenting to the surgery and are not being fully informed of its consequences.

Women may be the most harmed by the promotion of male circumcision. In addition to the false sense of security reducing safe sex practices, male circumcision INCREASES the risk of HIV transmission to women before the wound is fully healed [vii]. A 2008 WHO report found that 1 out of 4 circumcised African males still had not fully healed at 60 days post operative [viii].

Of particular ethical concern is the recent increase in advocacy for neonatal circumcision to prevent HIV. Neonatal circumcision places newborns at immediate risk of infection, hemorrhaging, penile damage and in rare cases even death (xi, xii). It is unethical to place newborns in the immediate risk of these complications to potentially reduce their risk, if at all, of acquiring HIV 15-20 years later when other prevention methods may exist.

"Ferris concludes, "the promotion of male circumcision for HIV prevention is fraught with logistical, monetary, ethical and human rights concerns. Proponents of circumcision have yet to suggest a long term monitoring system in order to evaluate failure or success of the exaggerated claims based on the three RCTs which are in contrast with real world population samples. While the world is desperate for a silver bullet to end the HIV epidemic, the use of male circumcision is not the answer that we have been waiting for.

"Wilfred Ascott - NOCIRC-SA: Communications Advisor - wilfred@nocirc.sa.co.zaDean Ferris - NOCIRC-SA: National Coordinator - dean@nocirc-sa.co.za

NOCIRC-SA - National Organisation of Circumcision Information Resource Centres – South Africa www.nocirc-sa.co.zainfo@nocirc-sa.co.za

REFERENCES:

[i] Garenne M, Long-term population effects of male circumcision in generalized HIV epidemics in sub-Saharan Africa. African Journal of AIDS Research 7(1), 1–8 (2008).

[ii] Connolly C, et al., Male circumcision and its relationship to HIV infection in South Africa: Results of a national survey in 2002 S Afr Med J 98, 789–794 (2008).

[iii] Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV prevention: a prospective study of complications in clinical and traditional settings in Bungoma, Kenya. Bull, WHO 86(9), 657–736 (2008).

[iv] McAllister RG, Travis JW, Bollinger D, Rutiser C, Sundar V. The Cost to Circumcise Africa. Int. J, Men's Health 7(2), 307–316 (2008).

[v] Nyakairu, F. Uganda turns to mass circumcision in AIDS fight. Reuters Africa 13 August (2008). http://www.canada.com/topics/ bodyandhealth/sexualhealth/ story.html?id=2788448d-1b51-44e2-9fef-ab591d723ad7 (March 2, 2009).

[vi] Irin, Swaziland: Circumcision gives men an excuse not to use condoms. UN Office for the Coordination of Humanitarian Affairs 31 July (2008). http://www.irinnews.org/Report.aspx?ReportId=79557 (March 2, 2009).[vii] Wawer M, Kigozi G, Serwadda D, et al. Trial of male circumcision in HIV+ men, Rakai, Uganda: effects in HIV+ men and in women partners. 15th Conference on Retroviruses and Opportunistic Infections 3–6 February, Boston. Abstract 33LB (2008).

[viii] Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV prevention: a prospective study of complications in clinical and traditional settings in Bungoma, Kenya. Bull, WHO 86(9), 657–736 (2008).

[ix] Cold CJ, Taylor JR. The prepuce. BJU Int. 83 Suppl.1, 34–44 (1999).

[x] Gusongoirye D. Rwanda: Nothing can fight HIV/AIDS better than discipline. The New Times (Kigali) 12 February (2008).

[xi] Williams N, Kapila L. Complications of circumcision. Brit. J. Surg. 80,1231–1236 (1993).

[xii] Paediatric Death Review Committee: Office of the Chief Coroner of Ontario. Circumcision: a minor procedure? Paediatr. Child Health 12(4), 311–312 (2007).