Monday, February 25, 2013

HESSE, GERMANY: Charges dropped against circumcising rabbi

Haaretz
February 24, 2013

German prosecutor drops anti-circumcision charges against mohel


by

Court says Hof chief rabbi, David Goldberg, who was charged in 2012 after a Cologne court ruled circumcision illegal in Germany, satisfies child welfare requirements.

A statement by the Hof prosecutor on February 21 said that Rabbi David Goldberg of Hof satisfied all requirements regarding child welfare “which are not jeopardized by the circumcision,” the Jewish-German publication J├╝dische Allgemeine reported.

“Circumcisions which are applied with the consent of parents or custodians are not subject to criminal liability,” the prosecutor added. [The prosecuter seems to interpret the new law retrospectively.]

Charges were brought against Goldberg last year after a court in Cologne ruled that circumcision was illegal in Germany. Goldberg, who has been working as a mohel in Germany since 1997, said he was very pleased the case was now closed and that there was clarity on the issue.

“I never had any doubts, I still performed circumcisions,” he said. "But I think this is very good news for parents who did have doubts, and for the entire Jewish community.”

The German parliament has since passed a new law allowing circumcision, with some restrictions.

Earlier story

Saturday, February 23, 2013

NEW YORK: Metzitzah: Federal court upholds consent form

They just don't give up, do they?

Jewish Daily Forward
February 22, 2013

Federal Court Refuses To Block New York Circumcision Consent Form Law


Rejects Metzitzah B'Peh Motion Filed by Orthodox Groups

by Seth Berkman

Proponents of metzitzah b’peh, the controversial circumcision ritual, were denied a request for an emergency stay in the enforcement of a recent New York City law that regulates the procedure. The decision was handed down by the United States Court of Appeals for the Second Circuit.

The motion, filed by the Central Rabbinical Congress of the USA & Canada, Agudath Israel, the International Bris Association and a group of rabbis, failed “to meet requisite standards,” according to the court.

...

Recent studies by the New York City DOHMH have revealed 12 area infants who have contracted herpes after circumcision, with two of the infants dying soon after.

JAKARTA: Boy with haemophilia bleeds after circumcision (!)

Jakarta Post
February 21, 2013

Toddler with hemophilia bleeds after circumcision


by Panca Nugraha

Haikal Syafi’i, a three-year-old with hemophilia, has been receiving repeated treatment in hospital for severe bleeding from a circumcision wound.

Haikal from Lombok, West Nusa Tenggara (NTB), was taken to Gerung Hospital in Lombok Barat after a mass circumcision event last month . He continued to suffer constant bleeding so his parents took him to Bhayangkara Hospital in Mataram, NTB.

“After receiving treatment in those two hospitals, his bleeding continued; so, he was brought to NTB General Hospital (RSUP) on Monday. We found that Haikal is suffering from hemophilia, a disorder in the blood clotting process,” the hospital’s Lalu Ahmadijaya, told The Jakarta Post, on Thursday.

Hemophilia is a genetic disorder that affects mainly boys, famously prevalent in the royal families of Europe.

“This should be a lesson for our people that they should check the health conditions of their children before circumcision.” said Ahmadijaya.

Speaking to the Post, Haikal’s mother, Sanemah, said that her boy attended a mass circumcision with seven other boys from their kampung on Jan.27 to commemorate the Prophet Muhammad’s birthday.

“After being circumcised, he had no complaints. But four days after the procedure, he began bleeding from his circumcision wound,” she said.

“Hemophilia treatment can be costly. Koate, for example, costs around Rp 10 million (US$1,030) per injection and Haikal needs three injections to stop his bleeding,” Ahmadijaya said, adding that Haikal’s treatment would be covered by the government-fund health coverage scheme Jamkesmas. (ebf)

Thursday, February 21, 2013

SASKATOON: Father's status more important than "reasons" to cut

Canadian Family Physician (also on this site)
February, 2013

Father's status influences circumcision decision

by Hugh Young

A study in Saskatoon, Saskatchewan, has found that regardless of the reasons parents give to circumcise, the father's status is an important factor in the decision.

Medical student Chris Rediger and his supervisor Dr Andries Muller surveyed 230 people at prenatal classes in the Saskatoon Health Region over a 3-month period.

Of all parents responding who were expecting children, 56.4% indicated they would consider pursuing elective circumcision if they had a son; 24.3% said they would not. They were asked before any prenatal classes, which may have changed their final decision.

The reasons they most often gave for supporting male circumcision were hygiene (61.9%), prevention of infection or cancer (44.8%), and the father being circumcised (40.9%). The reasons most commonly reported for not supporting circumcision were it not being medically necessary (32.0%), the father being uncircumcised (18.8%), and concerns about bleeding or infection (15.5%).

But when the expecting father was circumcised, 81.9% of respondents were in favour of pursuing elective circumcision. When he was not circumcised, only 14.9% were in favour of pursuing elective circumcision. The result was statistically significant.

Father's status and circumcision preference - Rediger

The father's circumcision status also influenced whether parents-to-be thought circumcision was safe. 82.2% with a circumcised father-to-be thinking circumcision by an experienced medical practitioner was a safe procedure for all boys, and none thinking it unsafe, compared to 64.1% of couples with an intact father-to-be thinking it safe and 7.8% thinking it unsafe.

Tuesday, February 19, 2013

NOTTINGHAM: African HIV trials fudged registration dates

So what else did they play fast and loose with?

Ripe Tomatoes, September 13, 2013


Circumcision and HIV

Two out of three key trials registered late

Does circumcision of adult men reduce HIV transmission? Initial scepticism, surely the foreskin reduces friction between penis and vagina, and prevents abrasions and blood transfer, and conflicting observational data, were eventually overcome by three randomised trials, one each from South Africa (click here), Kenya (click here) and Uganda (click here). In each trial men were randomly allocated to immediate circumcision or to wait for two years. All three trials showed about half the number of new HIV infections in the immediate circumcision group. The relevant Cochrane review (click here) summarises them as follows:

“The resultant incidence risk ratio (IRR) was 0.50 at 12 months with a 95% confidence interval (CI) of 0.34 to 0.72; and 0.46 at 21 or 24 months (95% CI: 0.34 to 0.62). These IRRs can be interpreted as a relative risk reduction of acquiring HIV of 50% at 12 months and 54% at 21 or 24 months following circumcision.”

The Cochrane reviewers judged “the potential for significant biases affecting the trial results [as] low to moderate”. Referring to selective reporting they wrote “All three trials clearly stated in their protocols that the primary outcome was HIV incidence. The risk of bias due to incomplete outcome reporting is therefore low in all three trials.”

The trial protocols have not been published so we have to trust that the Cochrane reviewers interpreted them correctly. But if they relied on trial registration documents (click here, for South Africa, here for Kenya and here for Uganda) they would have been misled. They they all indicate more of less the same primary outcomes and planned sample sizes as in the respective papers. But according to the date of first entry, only the Kenyan trial was prospectively registered. The South African trial was registered a year and a half after recruitment ended and seven days before the results were published! The Ugandan one a month after recruitment ended,and a month before publication.

Recruitment period Date of 1st publication of results 1st trial registration date Registry planned sample size Primary outcome in registry Primary outcome in paper
South Africa July 2002 – Feb 2004 26 July 2005 July 19 2005 3274 planned.
3274 in paper
HIV infection at 3, 12 and 21 months All HIV infections at 3, 12 and 21 months
Kenya Feb 2002 – Dec 12 2006 24 Feb 2007 April 23 2003 Initially 3,000. Altered to 2887 in registry.
2784 in paper
HIV incidence at 2 years
Complications of circumcision
HIV incidence after three interim analyses
Uganda August 2002 – Dec 2006 24 Feb 2007 Jan 23 2007 5,000 planned
4996 in paper.
HIV acquisition no time point specified HIV incidence

It looks like PLOS One and The Lancet wanted to publish sexy high impact trials, found they weren’t registered, so got the authors to do it retrospectively, and hoped no-one would notice! All three trials were funded by the public sector.

Jim Thornton (Professor of Obstetrics and Gynaecology at Nottingham University)

BRAZIL: Circumcision kills one in 7700 (=156 deaths/p.a. in the USA)

Einstein (Sao Paulo) 2012 Sep;10(3):342-346.

Circumcisions for medical reasons in the Brazilian public health system: epidemiology and trends.

Korkes F, Silva Ii JL Pompeo AC

Abstract
OBJECTIVE
:
To evaluate the epidemiological factors associated to medical circumcision, based on data from the Brazilian public health system.

METHODS: Using the Unified Health System public database between 1984 and 2010, hospital admissions associated with surgical treatment of phimosis were searched. A total of 668,818 men admitted to public hospitals who underwent circumcision were identified and included in the present study.

RESULTS:
A mean±standard deviation of 47.8±13.4 circumcisions/100,000 men/year was performed through the Unified Health System for medical reasons. During the 27-year period evaluated, 1.3% of the male population required circumcision for medical reasons. [So 98.7% of routine circumcisions are wasted on boys and men who will never need it.] Total number of circumcisions and circumcision rate increased in childhood, declined progressively after 5 years of age and rose again progressively after the sixth decade of life. In the regions of the country with better access to healthcare, 5.8% of boys aged 1 to 9 years old required circumcisions. [Or were circumcised whether they needed it or not.] From 1992 to 2010 there were 63 deaths associated with circumcisions (mortality rate of 0.013%).

[That's one death in 7692 circumcisions. In this USA, that would amount to 156 circumcision deaths per year.]

CONCLUSION:
In conclusion, yearly circumcision rates could be estimated in Brazil, and a very low mortality rate was associated with this procedures. Circumcision is mostly performed in children in the first decade of life and a second peak of incidence of penile foreskin diseases occurs after the sixth decade of life, when circumcision is progressively performed again.

[This study was circulated by Prof. Brian Morris, who presumably thinks this is an "acceptable" death rate.]

CANBERRA: Circumcising doctors restricted, one must see psychiatrist

Canberra Times
February 17, 2013

Unkindest cut: Restrictions placed on doctors


by Phillip Thomson

Several doctors have had restrictions placed on them by the ACT Medical Board.

THE national watchdog has slapped restrictions on more than 40 Canberra health practitioners to ‘‘protect the public’’.

Those with restrictions placed on them include one practitioner under scrutiny for the way he performs circumcisions, with the regulator stating he is not to perform circumcisions without the use of adequate pain relief and that he must use the correct equipment during these procedures. [So what equipment was he using?]

Until the end of 2013, the doctor must list for the ACT Medical Board each circumcision he has performed and the anaesthetic used in each procedure.

The doctor’s future use of analgesics during circumcisions must be in line with the Royal Australian College of Physicians guidelines and he must see a psychiatrist paid for and appointed by the medical board.

He has been allowed to choose his own mentor who was to supervise him for six months and write a report for the board.

The doctor declined to comment when contacted

...

Friday, February 15, 2013

BELGIUM: Circumcised men get less pleasure

Reuters
February 14, 2013

Male circumcision tied to less sexual pleasure

by Andrew M. Seaman
(Reuters Health) - Men circumcised either as children or adults report less intense sexual pleasure and orgasm than their uncircumcised counterparts, according to a new study from Belgium.

"We're not saying less sexual activity or satisfaction, but sensitivity," said the study's senior researcher Dr. Piet Hoebeke, from Ghent University Hospital.

The new study surveyed 1,369 men over the age of 18, who responded to leaflets handed out in train stations across Belgium.

The men were asked whether they were circumcised, and were then asked to rate how sensitive their penis was, how intense their orgasms were and whether they experience any pain or numbness when they are aroused.

Overall, 310 men who took the survey were circumcised, and 1,059 were not. Each rated how sensitive their penis was on a scale from 0 to 5, with higher numbers being the most sensitive.

Overall, uncircumcised men reported between 0.2 points and 0.4 points higher sensitivity and sexual pleasure when their penis's head - known as the glans - was stroked during arousal, compared to circumcised men.

For example, uncircumcised men reported an average sensitivity score of 3.72 when they or their partner stroked the top part of their penis's glans, compared to 3.31 amongst circumcised men.
Uncircumcised men also reported more intense orgasms.

"It's not a very big difference in sensitivity, but it's a significant difference," Hoebeke said.

Currently, about half of U.S. baby boys have their foreskin surgically removed at birth, and about 30 percent of men around the world are circumcised.

Some religions, such as Judaism and Islam, consider circumcision part of religious practice, while other people choose circumcision for possible health benefits - including a reduced risk of urinary tract infections (see Reuters Health article of December 7, 2012 here:).

Hoebeke and his colleagues write in BJU International that there are few studies researching whether foreskin plays a role in sexual pleasure. But Dr. Aaron Tobian, who studies circumcision but was not part of the new study, said that previous randomized controlled trials - considered the gold standard of medical research - looked at sexual performance and satisfaction. [They were studies of adult volunteers for circumcision - not the gold standard at all.] Those studies, he said, did not find a difference. [Becauses the questions were too vague to do so.]

One possible explanation for any potential difference in sensitivity is that a man's foreskin may protect his penis's head from rubbing against underwear and clothing. It's possible, the researchers write, that friction makes the head of the penis thicker, drier and ultimately less sensitive. [Another is simply that the foreskin itself is sensitive, as Taylor found.]

The researchers also found circumcised men were more likely to report more pain and numbness during arousal than uncircumcised men, which Hoebeke said is likely due to scar tissue.
"I'm amazed that people report pain during sexual pleasure… That's very amazing and that was unexpected," he said.

‘ABUNDANTLY CLEAR' EVIDENCE
Tobian, from Johns Hopkins University in Baltimore, said the findings are missing important context.
"The medical evidence and the benefits of male circumcision are abundantly clear," Tobian told Reuters Health. [This is not "context", but another issue altogether.]

"If there was a vaccine out there that reduces the risk of HIV by 60 percent, herpes by 30 percent and the penile cancer causing HPV by 35 percent, the medical community would rally behind it," said Tobian. [There is little or no evidence that circumcision does any of those things.]

The American Academy of Pediatrics says the benefits of male circumcision outweigh the risks, but stops short of recommending universal circumcision (see Reuters story of August 27, 2012 here:).

SOURCE: bit.ly/X7j39D BJU International, online February 4, 2013.

Wednesday, February 13, 2013

TANZANIA: Campaign to COMPEL men to be circumcised

AllAfrica.com
February 11, 2013


Tanzania: Handeni Promotes Male Circumcision to Curb HIV Spread


Handeni — HANDENI district have launched a campaign to compel men in the area to undergo circumcision as a preventive measure against HIV/AIDS.

The campaign was announced over the weekend by the District Medical Officer (DMO), Dr Somoka Mwakapalala, when speaking during a public rally at Kabuku ward on the last leg of Tanga Regional Commissioner Chiku Gallawa's tour of Handeni.

The RC wanted to know measures that the district has taken so far in sensitizing the public on preventive measures against HIV/AIDS especially those living along highways where the infection rate is still high.

The DMO said apart from sensitizing the people to be faithful to their partners, abstain from sex or use condom, the district had also launched a campaign of encouraging men to undergo circumcision.

According to Dr Mwakapalala, circumcised men have lower chances of being infected with the deadly virus than those who are uncircumcised. He said health workers and activists in the district have been moving around the district to sensitize men do so bearing in mind that some tribes do not practice circumcision.

...

Tanzania
HIV Rates: Circumcised men6.5%
Intact men5.6%
Source: measuredhs.com/pubs/pdf/CR22/CR22.pdf
[We may hope that "compel" is faulty English, but this has been expected for a long time.]

NEW YORK: Metzitzah: Chasidim take offence at lottery ad

COLLive
February 7, 2013

Ad Uses Chassidim to Poke Fun


By COLlive reporter

A new commercial for the New York Lottery, using humor and exaggeration to portray what money can buy a lucky Powerball winner, might have pushed the line.

The TV spot, created by DDB New York ad agency, shows a man who has the perfect punch lines for any scenario, leaving people laughing hysterically wherever he goes.

In truth, the millionaire has employed a full-time team of comedy writers who feed him the jokes through an earpiece. He is "that kind of rich," the ad suggests.

One of the millionaire's punchlines is told to a group of Chassidic looking Jews seated in a deli.

"You're the herpetologist," the man tells them from a nearby eating booth, leading them to burst out in laughter.


A COLlive reader said it seemed like they were referring to the ongoing battle between the City of New York and the frum community over a custom of the bris milah (circumcision ceremony).

The City's Board of Health ["along with hundreds of the top infectious disease specialists and other public health specialists, including the US Centers for Disease Control and two major Israeli studies, one released in the past few days – but COLLive tells readers none of that" - thanks to Failed Messiah] says metzitzah b'peh (oral suction during the bris) can lead to fatal herpes infection. Rabbis and mohelim say there is no evidence to support that claim.

"This is no laughing matter and it's even frightening that the government is trying to regulate religious practice," Rabbi Levi Heber, the director of the International Bris Association, said in response to the Lottery commercial.

Speaking to COLlive, Heber said: "It's very unfortunate that people are not taking this matter seriously. The City's meddling in our rituals reminds many of Communist Russia. What's most ironic is that in Russia today Jews are more free to practice this mitzvah than in Brooklyn."

But what might be even more ironic is that the ad agency has mistakenly [or deliberately] used the term 'herpetologist' which is the occupation of a zoologist that specializes in reptiles, amphibians, crocodiles and turtles [and snakes, which one COLLive reader manages to extract further offence from, via the Yiddish word {schlange} for snake/penis.], with no connection to the herpes disease.

...

[What's distasteful and offensive is 1. cutting parts off babies' genitals, 2. sucking babies' {cut} genitals, and 3. passing off an informed consent form to sucking (but not to cutting) babies' genitals as a health-protection measure.]

MANCHESTER: Nurse escapes gaol for circumcision death

BBC
February 8, 2013

Nurse spared jail for killing baby in botched circumcision


A nurse who caused the death of a baby in a botched home circumcision has been spared jail.

Grace Adeleye, 67, carried out the procedure using scissors, forceps and olive oil and without anaesthetic in Chadderton, Oldham, in April 2010.

Four-week-old Goodluck Caubergs bled to death before he could reach hospital the following day.

Adeleye, who was found guilty of manslaughter by gross negligence, was given a suspended jail sentence.

A judge at Manchester Crown Court ordered her to serve 21 months in jail, suspended for 24 months.

'No problem'
She was also given a six-month overnight curfew [apparently her only "penalty"] and a 12-month supervision order.

...

Goodluck's parents said after sentencing "not for one minute" did they think the procedure would cause him harm.

In a statement they described his death as "having a nightmare that we could not wake up from".

"The sadness we feel does not seem to ease. We have now just grown to live with the pain of our son's death rather than it subsiding."

Det Insp Darren Meeks from Greater Manchester Police said the case in which a young baby lost his life in such a "tragic and unnecessary manner" was "heartbreaking".

"Although Adeleye was a registered nurse, she carried out the surgery at the parents' home, using a historic, crude and dangerous method, with inappropriate instruments."

[If it had been any other operation, would she have escaped imprisonment?]

Earlier story

Friday, February 8, 2013

BERLIN: Female cutting growing in Germany

Jewish Press (!)
February 6, 2013

Female Circumcision Now a Growing Problem in Germany


For many of these women, urinating can take up to 30 minutes, and is very painful.

Between 130 and 150 million women are victims of genital mutilation – most of them are Africans, Deutsche Welle reports. Now, doctors, teachers and social workers in Germany report being confronted by this practice in ever growing numbers.

Jawahir Cumar, who moved to Germany with her parents from Somalia when she was a girl, witnessed, at age 20, on a visit to her grandparents’ village, the funeral of young girl who had bled to death after being “circumcised.”

Female genital mutilation (FGM) is practiced in 29 African countries, even though it is illegal in some of them. It is usually done when girls are between the ages of four and eight – using razor blades, kitchen knives and even broken glass and tin lids. Because these tools are used more than once, it also increases the spreading of bllod-based diseases like HIV/AIDS and hepatitis.

FGM alters or injures female genitalia for non-medical reasons, according to the World Health Organization (WHO). ...

An estimated 30,000 women living in Germany have been subjected to FGM and 6,000 girls are at risk, according to human rights organization Terre des Femmes.

Mothers-in-law and grandmothers, especially, call all the time, write letters and send messages,” says Cumar. And the message is always the same, “you have to cut your daughters! Or just bring them to us and we will do it.”

...

She was able to prevent 17 girls from being subjected to FGM last year. But there’s still a lot of work to be done in Germany as well, says Cumar, pointing to how long it took for “honor killings” to be viewed by police as a criminal offence and not simply as the customs of immigrants.

...

Monday, February 4, 2013

NEW YORK: Metzitzah: Rabbis will resist parental consent forms

The Jewish Daily Forward
January 30, 2013

Orthodox Rabbis Vow To Resist Consent Forms for Controversial Circumcision Rite


Balk at New York City Health Rule on Metzitzah B'Peh

by Seth Berkman

The leading association for mohelim who practice a risky oral blood suctioning technique in their circumcisions has vowed not to cooperate with New York City’s new health regulations governing use of the technique, known as metzitzah b’peh.

Brooklyn mohel Rabbi Avrohom Cohn, chairman of the American Board of Ritual Circumcision, said his group would not have parents sign waiver forms, which the city is now requiring as a condition for performing metzitzah b’peh.

“He’s the mayor of the biggest city in the world, but I’m not going to listen to him,” Cohn said, referring to New York City Mayor Michael Bloomberg, who has strongly backed the new rules. “I have another mayor, the Almighty, and I will do it His way.”

...

Failure by a mohel who practices metzitzah b’peh to produce the relevant signed consent forms on request is “a violation of the New York City Health Code,” the DOHMH said in a statement to the Forward. Violating that code can lead to “a range of penalties,” the department added, including fines up to $2,000.

Orthodox defenders of the practice have filed a notice of appeal to the U.S. Court of Appeals for the Second Circuit to reverse Buchwald’s ruling, but that is pending.

...
Now that the DOHMH rule is enforced, Orthodox defenders of the practice appear to be split on how to respond. David Zwiebel, executive vice president of Agudath Israel, an influential umbrella organization for ultra-Orthodox groups, said his organization has not issued any directive advising whether or not parents should sign the consent forms.
...
New York City council member Lewis Fidler told the Forward at that time that the regulation was “probably next to impossible to enforce.” Fidler said: “Will you have undercover agents at a bris? In the end this will probably be a regulation flagrantly violated.”

In its statement to the Forward, DOHMH said it had “no plans for continuous monitoring” of mohels. “DOHMH will request forms from mohelim when investigating neonatal herpes cases potentially caused by direct oral suction or when investigating complaints by parents about direct oral suction,” the statement said. [Fat lot of good it does a baby with herpes that his parents have given informed consent for him to be infected.]

Cohn said he was working with other mohelim to organize a “day of prayer” that would draw “millions of people” who believe “in the existence of God” to protest in front of Bloomberg’s office in City Hall.

“We’re working very hard, spending a fortune of money on this,” he said.

Niederman said he did not know of any planned protests and that official bodies involved in the lawsuit have never discussed such action.



Earlier story

KENYA, ZAMBIA: Dangerous circumcision clamp being used

January 30, 2013

Dangerous circumcision clamp still in use in Africa


by Hugh Young

While the Mogen circumcision clamp is no longer manufactured in the USA, the Mogen company having been driven out of business by legal action, Mogen clamps are still being tested in Africa with a view to circumcising babies to reduce HIV-acquisition. No study has shown infant circumcision has any effect on HIV acquisition.

In 2010, a Florida family won $10.8 million in damages from the Mogen company, after the glans (head) of their son's penis was partially cut off in a Mogen clamp. This followed another successful claim for $7.5 million. As a result the Mogen Company went out of business.

Now, two studies from Africa, involving Mogen clamps have been published, suggesting they should be used on babies there.

J Acquir Immune Defic Syndr. 2013 Jan 1;62(1):e1-6. doi: 10.1097/QAI.0b013e318275741b.
A controlled trial of three methods for neonatal circumcision in lusaka, zambia.
Bowa K, Li MS, Mugisa B, Waters E, Linyama DM, Chi BH, Stringer JS, Stringer EM.
Abstract
OBJECTIVE:

Neonatal male circumcision (NMC) is not routinely practiced in Zambia, but it is a promising long-term HIV prevention strategy. We studied the feasibility and safety of three different NMC methods.
METHODS:
We enrolled healthy newborns in a controlled trial of the Mogen, Gomco, and Plastibell devices. Doctors, nurses, and clinical officers were trained to perform Mogen, Gomco, and Plastibell techniques. Each provider performed at least 10 circumcisions using each device. Neonates were reviewed at 1 and 6 weeks after circumcision for adverse events.
RESULTS:
Between October 2009 and March 2011, 17 providers (5 physicians, 9 nurse midwives, and 3 clinical officers) without previous NMC experience were trained, and 640 circumcisions were performed. The median infant birth weight was 3.2 kg (interquartile range: 2.9-3.5 kg), and median age at the time of procedure was 11 days (interquartile range: 7-18 days); 149 babies (23.3%) were exposed to HIV. The overall adverse event rate was 4.9% (n = 31/630), and the moderate-severe adverse event rate was 4.1% (n = 26/630). Rates did not significantly differ by method. Most providers (65%) preferred Mogen clamp over Gomco and Plastibell.
CONCLUSIONS:
Doctors, nurses, and clinical officers can be trained to safely provide NMC in a programmatic setting. The 3 studied techniques had comparable safety profiles. Mogen clamp was the preferred device for most providers.

That is, one baby in 24 suffered a moderate-to-severe adverse event, and one baby in 20 any adverse event.

PLoS One. 2012;7(10):e47395. doi: 10.1371/journal.pone.0047395. Epub 2012 Oct 17
Safety [or danger] of over twelve hundred infant male circumcisions using the Mogen clamp in Kenya.
Young MR, Bailey RC, Odoyo-June E, Irwin TE, Obiero W, Ongong'a DO, Badia JA, Agot K, Nordstrom SK.
Abstract
BACKGROUND:

Several sub-Saharan African countries plan to scale-up infant male circumcision (IMC) for cost-efficient HIV prevention. Little data exist about the safety of IMC in East and southern Africa. We calculated adverse event (AE) rate and risks for AEs associated with introduction of IMC services at five government health facilities in western Kenya.
METHODS:
AE data were analyzed for IMC procedures performed between September, 2009 and November, 2011. Healthy infants aged 2 months [or less] and weighing 2.5 kg [or more] were eligible for IMC. Following parental consent, trained clinicians provided IMC services free of charge under local anesthesia using the Mogen clamp. Odds ratios and 95% confidence intervals were used to explore AE risk factors.
FINDINGS:
A total of 1,239 IMC procedures were performed. Median age of infants was 4 days (IQR=1, 16). The overall AE rate among infants reviewed post-operatively was 2.7% (18/678; 95%CI: 1.4, 3.9). There was one severe AE involving excision of a small piece of the lateral aspect of the glans penis. Other AEs were mild or moderate and were treated conservatively. Babies one month of age or older were more likely to have an AE (OR 3.20; 95%CI: 1.23, 8.36). AE rate did not differ by nurse versus clinical officer or number of previous procedures performed.
CONCLUSION:
IMC services provided in Kenyan Government hospitals in the context of routine IMC programming have AE rates comparable to those in developed countries. The optimal time for IMC is within the first month of life.

The Adverse Event frequency of 2.7% reported here is an order of magnitude greater than that reported by the AAP. Any claim the AAP makes of "the benefits exceeding the risks" is diluted by this. The AE rate is also higher than that of 1.7% reported by Weiss, Larke, Halperin and Schenker.

They report a [parental?] dissatisfaction rate of 4% and less than 1 in 10 of those would not circumcise their son again.

Earlier story

HELSINKI: AAP Policy; "routine circumcision is insane" - Paediatrics Professor

Pediatrics
January 22, 2013

Routine circumcision is insane


by Harry G Lindahl, Associate Professor of Paediatric Surgery
Helsinki University Children's Hospital


Re: "Circumcision Policy Statement" 130:3 585-586doi:10.1542/peds.2012-1989

The evolution of mammals gained speed about 65 million years ago, when a meteorite fell on Yucatan and killed the dinosaurs. For all that we know, at that time, the mammals had a foreskin. If the mammal foreskin would be such a harmful piece of tissue as the pro circumcision lobbyists claim, it certainly would have fallen off during the 65 million years of evolution. However, mammals, including the human species, still have a foreskin. Rat is the most successful mammal on this planet. It has a foreskin. Evolution is merciless, and whatever mistakes it makes about the less important organs, such as the brain or stomach, it certainly knows best about the reproductive organs.

Therefore, the claim, that there are health benefits in excising a piece of healthy tissue from the penis of a healthy neonate, is as absurd as would be the claim that amputating the left little finger of a neonate has health benefits. However, if you would make such an absurd claim, either of the prepuce or of the left little finger, you would have to provide the highest level of proof according to the principles of evidence based medicine. This means several randomized controlled studies performed by independent researchers, all having the same result. There is no such evidence, neither of the prepuce nor of the left little finger.

The AAP is having a "Circumcision task force". This is as absurd as having a task force for "The Routine Amputating of the Left Little Finger of a Neonate". Is the AAP insane? To an European Paediatric Surgeon it seems so.

Earlier story

VANCOUVER: Intactivists protest Oprah's foreskin facecream

Brandford Expositor (Canada)
January 23, 2013

Oprah protested for endorsing face cream made from foreskins


by Jim Morris

Demonstration against Oprah Winfrey's endoresment of foreskin-based cosmetics

Picture by James Loewen

VANCOUVER – Her advice may be followed by hordes of people, but a Vancouver group wants Oprah Winfrey to explain why she has endorsed an anti-wrinkle cream made with human foreskins.

Winfrey makes her first appearance in Vancouver on Thursday before a sold-out crowd at Rogers Arena.

But as crowds pack into the stadium, Glen Callender, founder of the Canadian Foreskin Awareness Project, will be outside with his supporters protesting Winfrey's support of SkinMedica.

Callender says it’s hypocritical of Winfrey to speak out against female genital mutilation, while saying it’s all right to use a face cream made from foreskins from circumcised infant males.

“Imagine how Oprah would respond if a skin cream for men went on the market that was made from parts of the genitalia of little girls,” Callender said. “That would be an outrage and rightly so.”

Callender expects “a dozen to two dozen people” to attend the protest.

Advertisements for SkinMedica say Winfrey has described the product as her “magic fountain of youth and miracle wrinkle solution.” Winfrey didn’t immediately respond to an email asking for comment.

The makers of SkinMedica have said they use foreskin fibroblast — a piece of human skin used as a culture to grow other skin or cells.

“I would like Oprah to come to her senses and realize that all children have a fundamental human right to keep all their genitalia and to decide for themselves if anything gets cut off,” Callender said Wednesday.

Callender describes the Foreskin Awareness Project as Canada's “feistiest pro-foreskin advocacy group” with the goal of “foreskin education and appreciation.”