Newborn undergoes surgery for bilateral cleft palate in time for Christmas

Throughout Joy Frederick’s pregnancy with her daughter Bella Rose, everything seemed completely normal. The soon-to-be mom experienced very little nausea, and all of her prenatal testing indicated that everything was going smoothly.

It wasn’t until Bella was born six months ago at Mount Sinai Hospital in New York City that Frederick noticed something was strange. Bella had two very large gaps in the roof of her mouth – a condition known as a bilateral cleft palate.

“Oddly enough, when I had sent a friend a sonogram during pregnancy, [Bella] had covered her mouth, so we didn’t know,” Frederick, who lives in Harlem with her husband Tyrone, told “The first time I saw her, she was looking at my mom, and [my mom] said, ‘She has a growth.’ Everyone was shocked and a little emotional.”

A rare congenital birth defect, bilateral cleft palates occur in one out of every 6,500 births in the United States every year. If left untreated, babies with this abnormality can have trouble eating, swallowing, gaining weight, learning proper speech and may experience many other complications as well.

Fortunately, the condition can be fixed through reconstructive surgery, so the doctors at Mount Sinai quickly discussed options with Frederick.

“We met Bella shortly after she was born,” Dr. Peter Taub, co-director of the cleft and craniofacial surgery program at Mount Sinai Hospital, told “We immediately set her up with our pediatric dentists, so they were able to build a little appliance for her.”

Before Bella could undergo surgery, she needed to be fitted with a prosthesis known as a palatal obturator. Similar to a dental retainer, the obturator slowly brings the pieces of the palate closer together, so that they are in a more ideal position for surgery.

“We take a mold of the upper jaw and the nose and lip that’s affected and fabricate a special appliance,” Dr. Alie Baba Attaie, assistant clinical professor of dentistry at the Icahn School of Medicine, told “The baby comes back within a few days, and we deliver the appliance and make adjustments and the baby wears the appliance full time. It helps the baby feed better and exert less energy to feed in the meantime.”

Just five days after Bella was born, Frederick took her daughter to Attaie, who fitted the newborn with her own obturator. Over the next few months, Attaie saw Bella once or twice a week, adjusting the prosthesis to bring her facial tissues closer together.

Though Frederick struggled to keep up with Bella’s various medical appointments and procedures, she knew that it would all be worth it in the long term.

“It wasn’t much of a choice,” Frederick said. “She wouldn’t have had the same quality of life. We wanted to get these things done as soon as possible, so there’s a chance that her teeth will come in properly.”

Finally, after about four months of wearing the obturator, Bella was ready for surgery.

“We just wanted [the pieces of the palate] as close as possible, so there’s not a lot of tension when we put sutures in the lip,” Taub said. “Surgery involves creating little flaps of tissue and muscles and putting everything together the way it should be. We make sure the muscle that encircles the mouth is re-approximated, and it can be difficult if two sides are very far apart.”

Just a month before Christmas, Bella underwent a four hour surgery to reconnect her facial tissues – and it went off without a hitch. While Bella will need more surgery in the future, her mouth and gums are now fully attached, and there are almost no signs of her once very severe cleft palate.

Source: DNA India

Google Glass surgeon’s new best friend? What one surgeon is saying about tech



It’s hard to think of a way we live that Google hasn’t touched. And now, you can add surgery to the

It all starts with Google Glass, which lets an expert lend a helping hand in the operating room, even
when he or she is in another state.

At the University of Alabama-Birmingham, orthopedic surgeon, Dr. Brent Ponce, prepared for a shoulder
replacement. Behind his face shield he wore Google Glass — the wearable computer. Its built-in camera
streamed live video of the procedure to another surgeon 150 miles away in Atlanta, where Dr. Phani
Dantuluri not only watched the surgery, but offered a virtual hand.

A ghostly projection of Dantuluri’s hands was superimposed over what Ponce saw on the operating table.
The merged images appeared in Ponce’s Google Glass display.
Asked what it was like when he first put on the Google Glass, Ponce said, “There’s a little bit of a
light bulb experience. We were able to say, not just ‘go left or right’ or ‘up or down,’ but we were
able to say ‘right here,’ ‘right there,’ ‘go faster from here to here’.”

On one day, Ponce and Dantuluri were testing Google Glass paired with VIPAAR, a videoconferencing
platform that allows users to interact with the picture.

It may be another year before the combined technology goes mainstream. Ponce is the only doctor testing
it in surgery.
Ponce said, “With this technology, if I’m struggling, another surgeon is able to say, ‘Hey, get your
head in the game. Let’s do this, let’s do this.’ And they’re able to walk through it together. So it’s a
little bit more of a safety net.”

Asked if it turns surgery into collaboration, Ponce replied, “Without question.”

VIPAAR plans to expand the pilot program to include more surgeons by the end of next year.

Source: cbs news

Guinness World Record for heart transplant patient

A British man has entered the record books as the worlds longest-surviving heart transplant patient.

John McCafferty, 71, has surpassed the previous Guinness World Record of 30 years, 11 months and 10 days set by an American man who died in 2009.

Mr McCafferty was told he had five years to live when he underwent the life-saving operation at Harefield Hospital in Middlesex 31 years ago.

He says his record should give hope to others awaiting transplants.

Mr McCafferty, from Newport Pagnell in Buckinghamshire, said: “I want this world record to be an inspiration to anyone awaiting a heart transplant and to those who, like me, have been fortunate enough to have had one.

“My advice is always to be hopeful, to look ahead with a positive mind, and, of course, to follow the expert medical advice.”

Mr McCafferty received his new heart on 20 October 1982 in a procedure carried out by world-renowned surgeon Sir Magdi Yacoub.

He had been diagnosed, aged 39, with dilated cardiomyopathy – one of the most common causes of heart failure. It leads to scarring of the heart wall and damage to the muscle, which causes the heart to become weakened and enlarged, preventing it from pumping efficiently.

The first ever successful heart transplant operation was performed in South Africa in 1967 by Prof Christiaan Neethling Barnard and a team of 30 physicians at the Groote Schuur Hospital, Cape Town. The patient, Louis Washkansky, survived for 18 days with the new heart.

Source: BBC news

14-pound baby born to Florida couple

The third baby may very well be the last for a north Florida couple.

Son Isaiah Lawrence Johnson was born Friday at Gainesville’s UF Shands Hospital, weighing in at a whopping 14 pounds 7.6 ounces. He was 22 ½ inches long.

Mother Nicia McNelley told the Gainesville Sun it seemed like it “took forever to get him out.”

The baby was born by cesarean section, seven days before his due date. The mother and baby are expected to leave the hospital Monday, just in time for Christmas.

McNelley and Quinta Johnson have two other children, but Isiah was their largest baby — by far.

They live in nearby Keystone Heights.

Source: abc local

Mother has Christmas wishes for family after her 2 years death

The wife and mother of four wanted three requests fulfilled when her husband found a life partner.

This holiday season, a local radio station has helped carry out the final wishes of a wife and mother of four in Des Moines, Iowa, who passed away two years ago at 46, CNN and the Des Moines Register report.

When Brenda Schmitz was dying of stage 4 ovarian cancer, she addressed a letter to Star 102.5 FM’s Christmas Wish program in August 2011 and instructed an anonymous friend to give it to the station only when her husband, David, found a new wife who would help raise their four sons.

A few months ago, David asked Jayne Abraham to marry him. A week-and-a-half ago, the station received the letter, and on Dec. 19, host Colleen Kelly broadcasted Schmitz’s three requests: a spa day for David’s fiancé, a “magical trip” for the whole family, and a night out “full of drinks, food and fun” for the nurses and doctors who took care of Brenda and all of the other cancer patients at Mercy Medical Center. Full text of the letter is embedded on the Des Moines Register‘s website as well.

Star 102.5 FM and local businesses are fulfilling all three wishes and have booked the family a vacation to Disney World. As the Iowa newspaper reports, “David said he hopes the story can help other people who have lost loved ones to ‘know someone is watching out for them, giving them guidance.’”
Source: Time News Feed

California family celebrates 3 heart transplants

A California family is celebrating this holiday season after the mother and two of her three sons all received life-saving heart transplants for an inherited cardiac condition.

Deanna Kremis and her sons, 17-year-old Matthew and 13-year-old Trevin, all suffer from hypertrophic cardiomyopathy. It’s a genetic condition that causes the heart muscle to thicken until the heart can’t pump blood properly.

Matthew and Trevin got their new hearts in 2007 within five weeks of each other. But as they got healthier, their mother – who was diagnosed as an adult – began to fail. She finally got a new heart in July and her sons are helping her adjust to her new life.

The transplants are not a cure: There is a constant threat of organ rejection and infection.

Source: Straits times

A girl dies in Ireland after pharmacy refuses to give her EpiPen

A teenage girl has died outside a pharmacy in Ireland after a staff member refused to give her family an EpiPen to inject her for a nut allergy because she didn’t have a prescription.

Emma Sloan, 14, was out for dinner in Dublin with her family when she accidentally ingested a sauce containing nuts that she mistook for curry, the Irish Herald reported.

The teenager suffered a severe allergic reaction but was not carrying an EpiPen, which delivers a shot of adrenaline that can reverse the effects of a severe, fast-acting reaction known as anaphylactic shock.

The family went to a nearby pharmacy and pleaded for an EpiPen but Emma’s mother, Caroline Sloan, said a male staff member refused to give them one without a prescription.

“He told me I couldn’t get it without a prescription. He told me to bring her to an A&E,” she told the newspaper.
Mrs Sloan said she tried to take Emma to Temple Street Hospital, but her daughter collapsed and died on the way.
“She died on the footpath. A doctor was passing and tried to help and put her into the recovery position. Ambulance and fire brigade men worked on her. But she was gone,” Mrs Sloan told the Herald.

“My daughter died on a street corner with a crowd around her. “I’m so angry I was not given the EpiPen to inject her. I was told to bring Emma to an A&E department. Emma was allergic to nuts and was very careful. How could a peanut kill my child?
“I want to appeal to parents of children with nut allergies to make sure their child always carries an EpiPen with them.”

Regulations prohibit the dispensing of EpiPen injections without a prescription, the Irish Herald reported.
Mrs Sloan said she had gone to an all-you-can-eat Chinese buffet with Emma and her two other daughters on Wednesday evening for a family meal.

While Emma was usually extremely careful about what she ate, on this occasion she overlooked a sign that warned a sauce contained nuts, Mrs Sloan said.

“Emma has always been very careful and would check the ingredients of every chocolate bar and other foods to be sure they didn’t contain nuts,” she told the newspaper.

“She had a satay sauce. She thought it was curry sauce because it looked like curry sauce and smelled like curry. I’m not blaming the restaurant because there was a sign reading ‘nuts contained’ but it wasn’t noticed. After a while, Emma began to say, ‘I can’t breathe, I can’t breathe’.”

Police and the pharmacy regulatory body, the Pharmaceutical Society of Ireland, have launched an investigation into the girl’s death.

Source: The Sydney Morning Herald

Pregnant woman kept on life support against husband’s wishes

A man reportedly is fighting a Texas law to get his pregnant wife removed from life support, which he says were her wishes before she was declared brain dead.

Texas man Erick Munoz found his wife Marlise unconscious on their living room floor at 2:00 a.m. on Nov. 26, WFAA in Dallas-Fort Worth reports. Munoz, a paramedic, began CPR and called 911, and his wife — also a paramedic — was taken to John Peter Smith Hospital in Fort Worth. She apparently experienced a pulmonary embolism, a potentially fatal blood clot.

“You just never think it’s going to be you,” he told the station.

Marlise was 14 weeks pregnant at the time, so doctors told the family they would provide all life-saving measures to her in order to comply with a rule under the Texas Health and Safety Code.

That rule states, “a person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient.”

But, Erick says he and his wife had discussed and mutually agreed upon “do not resuscitate” (DNR) orders, though one was never signed. She has not shown brain activity since, and doctors are unsure how long the fetus was without oxygen and nutrients, so it’s unknown whether the fetus is even viable.

“I don’t agree with this law… I don’t,” he said, adding, he doesn’t expect many people to side with him on this.

A hospital spokesperson told CBS News that the facility follows state law.

“Our responsibility at JPS Health Network is to be a good corporate citizen while also providing quality care for our patients,” J.R. Labbe said in an email. “In all cases, JPS will follow the law as it applies to healthcare in the state of Texas. And this specific state law says life-sustaining treatment cannot be withheld or withdrawn from a pregnant patient.”

One bioethicist not involved in the case considers the Texas law both unethical and unconstitutional, arguing it violates individual liberties.

Source: bossip

59 test positive for TB after Las Vegas outbreak

Las Vegas public health officials say dozens of people linked to a tuberculosis outbreak at a neonatal unit have tested positive for the disease.

The Southern Nevada Health District reported on Monday that of the 977 people tested, 59 showed indications of the disease, though all but two of the cases are latent — meaning patients don’t show symptoms and aren’t contagious.

Dr. Joe Iser, chief medical officer at the health district, said the report demonstrates the importance of catching tuberculosis early.

“We want physicians to really think about making the diagnosis and quarantining, and then calling us,” he said. “This has been very expensive for us in terms of time and effort and dollars.”

A state report released last month found that Summerlin Hospital Medical Center failed to recognize and take precautions to diagnose the infected woman’s contagious lung disease when she gave birth in May to premature twin daughters, and allowed the woman to continue visiting her babies after she was discharged.

One of 25-year-old Vanessa White’s babies died in June. White died in July at a Los Angeles hospital and was diagnosed with tuberculosis through an autopsy. Her other baby died of tuberculosis on Aug. 1 at Summerlin Hospital.

Iser said officials cannot know for sure that all 59 cases are directly linked to the Las Vegas hospital. Several of those tested are immigrants from countries where tuberculosis is more prevalent, and could have been exposed earlier in their lives, he said.

The health district is encouraging all 59 people to accept treatment.

TB is spread through the air when a sick person coughs, sneezes or speaks. Symptoms include coughing, chest pain, fever and fatigue. The disease usually attacks the lungs, but can affect other organs and can be fatal if not properly treated.

The Centers for Disease Control and Prevention counted 569 TB deaths in the U.S. in 2010, the most recent year for which data is available. The number of U.S. TB cases has been on a steady decline since a resurgence in 1992, and in 2012, reached the lowest level since national reporting began in 1953.

The Nevada Bureau of Health Care Quality and Compliance investigated the case, and determined that the Las Vegas hospital wasn’t taking proper precautions to contain infections.

In November, eight employees, former patients and visitors filed a negligence lawsuit seeking damages from the hospital. Family members of the young mother who died of the illness have said they also plan to sue.

In the fall, investigators found that 26 people, including the mother’s family members and hospital staff, had been infected.

Health officials then tested hundreds of babies, family members and staff who had passed through the neonatal intensive care unit. They contacted the parents of about 140 babies who were at the unit between mid-May and mid-August, and set up a temporary clinic to test them.

Health officials are expected to release a final report next summer.

They will continue to test the infants who passed through the hospital in the coming months, to ensure the babies don’t develop any signs of the disease.

“I try to think, what if it was my son or daughter, my newborn infant, what would I want to be done?” Iser said.

Source: Miami Herald

Judge orders Calif. hospital to keep teen declared brain dead on ventilator

With a family fighting a hospital to keep their daughter who has been declared brain dead on life support, a California judge on Monday ordered the hospital to keep treating 13-year-old Jahi McMath for another week as a second medical evaluation is conducted.

Jahi experienced complications following a tonsillectomy at Children’s Hospital in Oakland.

As her family sat stone-faced in the front row of the courtroom, an Alameda County judge called for Jahi to be independently examined by Paul Graham Fisher, the chief of child neurology at Stanford University School of Medicine.

The judge also ordered the hospital to keep Jahi on a ventilator until Dec. 30, or until further order from the court.

The examination was expected to occur later on Monday, and early Tuesday.

Hospital staff and Fisher will conduct an electroencephalogram, or EEG, and tests to see if blood is still flowing to Jahi’s brain.

Doctors at Children’s Hospital concluded the girl was brain dead on Dec. 12 and wanted to remove her from life support.

Jahi’s family wants to keep her hooked up to a respirator and eventually have her moved to another facility.

The family said they believe she is still alive and that the hospital should not remove her from the ventilator without their permission.

“It’s wrong for someone who made mistakes on your child to just call the coroner … and not respect the family’s feeling or rights,” Sandra Chatman, Jahi’s grandmother who is a registered nurse, said in the hallway outside the courtroom.

“I know Jahi suffered, and it tears me up.”

The family’s attorney also asked Judge Evelio Grillo to allow a third evaluation by Paul Byrne, a pediatric professor at the University of Toledo. The hospital’s attorney objected to Byrne, saying he is not a pediatric neurologist.

The judge is expected to take up the request to use Byrne, and another hearing was scheduled for Tuesday morning.

Byrne is the co-editor of the 2001 book “Beyond Brain Death,” which presents a variety of arguments against using brain-based criteria for declaring a person dead.

In a phone interview, Byrne said he could not comment in detail because he had not seen any of Jahi’s medical records. But the fact that her ventilator is still functioning properly is a sign that she is alive, he said.

“The ventilator won’t work on a corpse,” he added. “In a corpse, the ventilator pushes the air in, but it won’t come out. Just the living person pushes the air out.”

Jahi’s family says the girl bled profusely after a tonsillectomy and then went into cardiac arrest before being declared brain dead.

Outside the courtroom, Dr. David Durand, chief of pediatrics at Children’s, said that staff have the “deepest sympathy” for the family, but that Jahi is brain dead.

“The ventilator cannot reverse the brain death that has occurred and it would be wrong to give false hope that Jahi will ever come back to life,” he said.

Durand said Jahi’s surgery was “very complex,” not simply a tonsillectomy.

“It was much more complicated than a tonsillectomy,” Durand said. He refused to elaborate, citing health care privacy laws.

Arthur L. Caplan, who leads the Division of Medical Ethics at NYU Langone Medical Center and is not involved in Jahi’s case, told The Associated Press that once brain death has been declared, a hospital is under no obligation to keep a patient on a ventilator.

source: abc news