The Week That Wasn't: Birth Control Patch, Only-Child Obesity, Cat Scratch Sepsis

Donavyn Coffey


November 08, 2019

This week in the news, headlines touted birth-control patches, the obesity risk of only children, and a nearly deadly cat scratch. Here's why you didn't see those stories on Medscape.

Birth Control Patch

A microneedle patch could be the first do-it-yourself long-acting contraceptive, headlines promised. Researchers at the Georgia Institute of Technology designed a patch with 100 microneedles, each only 0.01 mm wide, that contained the contraceptive levonorgestrel.

"By manually pressing the patch to the skin, the [needles] painlessly penetrate into the skin's upper layers," the researchers write in an article published in Science Advances. As the needles degrade, they slowly release levonorgestrel over 60 days.

The researchers tested the patch on rats, and it successfully maintained levonorgestrel levels above the human contraceptive level for more than 1 month. Then the researchers tested a placebo patch containing no contraceptive in 10 female patients. In less than a minute, the needles successfully penetrated the skin and detached from the patch. The women reported no pain or swelling at 1 or 24 hours later. All said that they would prefer the patch to monthly injections, and 9 of the 10 said they would prefer the patch to a daily birth control pill.

Before heralding the rise of a new contraceptive option, it's worth noting that the purpose of the human experiment was simply to test acceptability. Efficacy data on the contraceptive patch were limited to the rat studies. The microneedles used in the placebo patch were made of a different biopolymer than the patch tested on rats, one that could not carry levonorgestrel. The authors write that injecting humans with the biopolymer used in the actual contraceptive patch was "beyond the scope of this study." To cover this story, Medscape would need to see data on how a patch containing actual levonorgestrel affects a much larger group of humans before it would be information valuable to clinicians treating patients interested in long-term contraceptive options.

Obesity in Only Children

Children without siblings are more likely to be obese, according to headlines about a new study from the University of Oklahoma. In an observational study, researchers looked at 68 mother-child dyads in which the child was 5 to 7 years old. Twenty-seven of the children in the study were only children and 41 had other siblings.

The researchers collected body measurements of mothers and children as well as questionnaires and food logs the mothers completed for the children. They found that only children had fewer healthy eating behaviors compared with children in larger families. Only children also scored lower on 3 of the 12 areas on the Health Eating Index from 2010.

While there was a correlation between only-child status and eating behaviors, that doesn't mean only-child status causes poor eating habits and obesity. The study authors suggest that larger families may have better eating behaviors because there's more time devoted to meal planning, but that's only speculation.

There are also several confounding factors in this observational study. For example, mothers of only children were also more likely to be obese, and maternal body mass index (BMI) was more closely associated with child BMI and waist circumference than whether a child had siblings. Because the study doesn't demonstrate why only-child status and obesity might be linked, it also can't inform how or whether physicians should counsel parents of only children on their eating behaviors differently than those with multiple children. With limited clinical relevance, we decided not to cover it.

Nearly Deadly Cat Scratch

A British woman nearly died, according to reports this week, after a seemingly harmless cat scratch led her to develop sepsis, septic shock, organ failure, pneumonia, and necrotizing fasciitis. She underwent emergency surgery to remove the infected tissue and had to be placed in a medically induced coma, Fox News reported. Subsequent surgery and skin grafts were required for her to recover completely.

While this story — and the gruesome photos that accompany it — certainly speak to the severity of flesh-eating bacterial infections, there was nothing unusual or unexpected about how the medical case unfolded. We didn't consider it newsworthy for busy physicians who are likely familiar with the symptoms and treatment for necrotizing fasciitis.

Donavyn Coffey is an editorial intern for Medscape.

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