This article from Time.com shares the story of two families that were successful in gaining the support of the courts and the public to get their children, who are suffering from cystic fibrosis, on the adult waiting list for organ transplants. Read about it here:
Score one for pushy parents. The families of two children with cystic fibrosis who need new lungs but were ineligible for adult organs have successfully used the courts and public opinion to get their daughter and son on the adult waiting list, which is normally unavailable to kids under 12.
On Wednesday, one of those children — Sarah Murnaghan, 10, whose family escalated their daughter’s quest for donor lungs to federal court — was reportedly receiving a transplant. “Sarah got THE CALL,” wrote her mother, Janet Murnaghan, on Facebook. “Please pray for Sarah’s donor, her HERO, who has given her the gift of life. We are overwhelmed with emotions!!!!”
Sarah’s parents and those of Javier Acosta, 11, didn’t do anything that any desperate mom or dad in their heartbreaking situation wouldn’t try. But their success raises a disconcerting question: are organ transplant rules made to be broken?
Sarah’s family had already made headlines by launching a petition on Change.org calling attention to her plight. Last week, the families of both children, hospitalized together at Children’s Hospital of Philadelphia, sued to change rules that limit kids under 12 to lungs from donors their age. A federal judge ordered the Organ Procurement and Transplantation Network (OPTN), which oversees transplant guidelines in the U.S., to temporarily lift the age restrictions, effectively broadening the pool of potential organs.
With lung transplants, size matters. How well transplanted organs nestle into the ribcage is important. Adult lungs can be too large for a child’s body.
On Monday, OPTN’s executive committee amended its policy to allow transplant surgeons to review the individual cases of kids under 12 in need of a lung transplant. The surgeons would decide, on a case-by-case basis, whether a child should be eligible for adult lungs as well. The new policy is set to expire July 1, 2014, though experts will spend the year leading up to then deciding whether permanent changes are required.
As gripping as these two particular cases are, they are only a snapshot of two families grappling with one disease. There are countless other conditions that land a person on a transplant list, and each organ has different criteria for who is first in line.
“An important feature of the system by which the United States has decided to allocate organs is equity. Equity means different things for different organs,” says Jeff Kahn, a professor of bioethics and public policy at Johns Hopkins’ Berman Institute of Bioethics.
About a decade ago, Kahn served for five years on the ethics committee of the United Network for Organ Sharing, which is federally contracted to allocate organs. He recalls the rules governing organ transplants being deliberated over and hashed out, ad nauseam. “There is lots and lots of process before you get to a policy,” says Kahn. “When I teach bioethics, we talk about justice. When you have a pie, how do you divide it fairly?”
When it comes to kidney transplants, for example, there’s been increasing consensus that it’s not equitable to transplant the kidney of a twentysomething into an octogenarian. “There was concern that we were leaving some ‘life’ in kidneys that were going into 80-year-olds,” says Kahn. “We have to think about how we can get the biggest bang for the buck.” There is now a proposed change to kidney transplant allocation rules that limits the age gap between donor and recipient to about 20 years.
(MORE: How OkCupid Led an Organ Donor to Find the Teen with His Kidney)
In 2005, a new process to rank who gets adolescent and adult lungs went into effect. The Lung Allocation Score, or LAS, was developed by OPTN staff members, who descended upon transplant centers nationwide to scrutinize patient records and determine a scoring mechanism that prioritizes the most urgent cases. Among many factors, LAS takes into account how sick a person is and how well he is expected to do with a transplant.
Because there were not enough pediatric lung transplants to provide data to develop an LAS for kids, the organ network settled on different criteria in 2010 that separates children into two tiers of medical urgency: priority 1 and priority 2. Priority 1 kids, for example, must be permanently connected to a ventilator.
Both methods of ranking patients’ need are “constantly tweaked and updated,” says Anne Paschke, a network spokeswoman. “They are constantly looking at ways to improve all our transplant policies to make the best use of the organs we have.”
It’s challenging to craft policies that are authoritative yet flexible, says Dr. Benjamin Wilfond, director of the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s Hospital. “We don’t know what the best rules are,” says Wilfond, who began his career as a pediatric pulmonologist, taking care of cystic fibrosis patients just as transplants were becoming an option a few decades ago.
“We make the best rules with the best information we have,” he says. “As time goes on, we figure out that some rules we were following may not have been the best rules, and we adjust them in one direction or another.”
This is the first time a court order has been issued on transplant rules. To abide by the ruling, the network had to create separate listings for Sarah and Javier with fake birthdates to fool the system into thinking they were 12.
The ruling has the potential to create preferential treatment for just a small subsection of patients — kids between about the ages of 5 and 11. The bodies of babies and toddlers are too tiny to accommodate adult lungs. But the expanded scope also raises new questions. What about small adults, for example? Should they now be added to the wait list for pediatric donors?
As of June 7, more than 1,650 people in the U.S. are waiting for a lung transplant, and 30 of them are children under 10. Forty children are between the ages of 11 and 17. Each patient, each family, is buffeted by despair and hope as they await the phone call that may change their life. Not everyone will get that call informing them that a compatible organ is available, which highlights another problem — not just allocation rules but the critical shortage of organs. “With 18 people dying every day on the transplant list,” says Paschke, “we don’t think it will ever feel fair to everyone.”
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Everyone has natural pacemakers. Known as the sinoatrial node, this bundle of neurons sends out electric signals at regular intervals, hence causing the heart to beat at 60 to 100 beats per minute. This system, more commonly known as the cardiac conduction system, keeps a person’s heart beating throughout the day.
But it is not always the case that the sinoatrial node will work normally. A myriad of medical conditions can cause it to act aberrantly, which can result to arrhythmia, a potentially fatal condition characterized by an irregularity in the rate or rhythm of the heartbeat.
On the occasion that the sinoatrial node fails to perform its function and the condition is already beyond pharmacologic remedy, doctors may advise their patients to have artificial pacemakers installed.
Artificial pacemaker systems are usually made up of a battery, a computerized generator, and electrodes (wires with sensors). The battery provides the needed electrical power to run the generator, while the electrodes connect the system to the heart. These electrodes detect the heart’s electrical activity, which then sends data through the electrodes back to the computer which is built in the generator.
If the computer detects an abnormal heart rhythm or rate, it will order the generator to send electrical pulses which will help normalize the heart activity. Some models of artificial pacemakers have the ability to monitor the blood temperature, breathing, and other factors, and adjust the heart rate/rhythm to activity changes.
To boost the country’s coffers, Rwanda aims to be the premier medical travel destination in Africa. However, in order to do that, the country has to attract more investors to build more world-class facilities similar to what they have in the country right now.
The country is doing this to further revitalize its travel industry, hoping to attract millions of African patients from across the continent. Currently, its travel industry is seeing a slow but steady growth, seeing a 22-percent increase in 2012 compared with that in 2011. Its government believes that medical travel is the key that can help them further enhance the growth of its travel sector. But before it can transform itself into a premier medical travel destination, it needs better hospitals, highly trained personnel to operate those hospitals, and better medical practitioners and specialists, and since the government does not have enough money to do so, it has to rely on foreign investors to do it for them. Building Rwanda to better handle the influx of medical travelers will also benefit the locals, as currently, there is a shortage of doctors and health care waiting time is long.
However, transforming Rwanda into a medical travel hub is more than just getting investors to build facilities; there has to be synergy between the government and the private sector for this to succeed.
Satori World Medical, US’ leading medical travel services company, features state-of-the-art hospitals in eight countries and the US territory of Puerto Rico. For more information on medical travel and how it can change your life, visit this website right now.
What is mycobacterium abscessus? This USNews.com article provides the answer.
FRIDAY, March 29 (HealthDay News) — Drug-resistant bacteria that cause lung infections in people with cystic fibrosis can be passed indirectly from person to person, a new study finds.
Between 3 percent and 10 percent of cystic fibrosis patients in the United States and Europe are infected with multi-drug resistant Mycobacterium abscessus, and the numbers are rising. The difficult-to-treat infection causes progressive lung damage.
In this study, researchers conducted DNA tracking of a multi-drug resistant M. abscessus outbreak that occurred among 31 cystic fibrosis patients at a British treatment center between 2007 and 2011.
Despite tight infection-control measures, patient-to-patient transmission was common, according to the study, published online March 29 in the journal The Lancet.
The researchers were unable to pinpoint the exact method of cross-infection between the patients. They said it likely occurred through contamination of things such as hair, clothing and bedding, or when bacteria were released into the air during procedures such as lung function tests.
The findings will have a major effect on how cystic fibrosis patients are cared for in hospitals and raise questions about the effectiveness of current infection-control measures and the risk of multi-drug resistant M. abscessus cross infection in other groups of patients, said Dr. Andres Floto, of the University of Cambridge, and colleagues.
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In a statement on its journal Stroke, the American Heart Association revealed that the costs of stroke treatment are likely to increase by 20% by 2013. This projection is a worrisome one, especially for the 45 to 64-year-old demographic, which is considered to be at highest risk of suffering from a stroke.
Among this demographic, those suffering from depression are known to have higher risks of stroke. Meanwhile, a new study now suggests that the association is even stronger in younger women.
A study conducted by Australian researchers tracked about 10,500 women with the average age of 52 and without a history of stroke. The women were surveyed every three years for 12 years, and it was found that about 24 percent were depressed at each survey.
The researchers found that depression almost doubled the risk for stroke, even when factors like age, education, blood pressure, heart disease, alcohol intake, physical activity, smoking, diabetes, and body mass index were accounted for. A previous study on the same subject found that the risk was increased by 30 percent, although the average age in the 2011 study was 14 years older. Additionally, there are studies that found no increased risk in people over 65.
The study is considered as merely an addition to the growing body of knowledge on the effect of depression on the risks of certain diseases on people. Larger studies are needed to determine whether depression truly does nearly double the risks in younger women.
Scientists have long proven that natural settings can help people manage stress. This New York Times article sheds light on how a simple walk in the park can ease brain fatigue.
Scientists have known for some time that the human brain’s ability to stay calm and focused is limited and can be overwhelmed by the constant noise and hectic, jangling demands of city living, sometimes resulting in a condition informally known as brain fatigue.
With brain fatigue, you are easily distracted, forgetful and mentally flighty — or, in other words, me.
But an innovative new study from Scotland suggests that you can ease brain fatigue simply by strolling through a leafy park.
The idea that visiting green spaces like parks or tree-filled plazas lessens stress and improves concentration is not new. Researchers have long theorized that green spaces are calming, requiring less of our so-called directed mental attention than busy, urban streets do. Instead, natural settings invoke “soft fascination,” a beguiling term for quiet contemplation, during which directed attention is barely called upon and the brain can reset those overstretched resources and reduce mental fatigue.
But this theory, while agreeable, has been difficult to put to the test. Previous studies have found that people who live near trees and parks have lower levels of cortisol, a stress hormone, in their saliva than those who live primarily amid concrete, and that children with attention deficits tend to concentrate and perform better on cognitive tests after walking through parks or arboretums. More directly, scientists have brought volunteers into a lab, attached electrodes to their heads and shown them photographs of natural or urban scenes, and found that the brain wave readouts show that the volunteers are more calm and meditative when they view the natural scenes.
But it had not been possible to study the brains of people while they were actually outside, moving through the city and the parks. Or it wasn’t, until the recent development of a lightweight, portable version of the electroencephalogram, a technology that studies brain wave patterns.
For the new study, published this month in The British Journal of Sports Medicine, researchers at Heriot-Watt University in Edinburgh and the University of Edinburgh attached these new, portable EEGs to the scalps of 12 healthy young adults. The electrodes, hidden unobtrusively beneath an ordinary looking fabric cap, sent brain wave readings wirelessly to a laptop carried in a backpack by each volunteer.
The researchers, who had been studying the cognitive impacts of green spaces for some time, then sent each volunteer out on a short walk of about a mile and half that wound through three different sections of Edinburgh.
The first half mile or so took walkers through an older, historic shopping district, with fine, old buildings and plenty of pedestrians on the sidewalk, but only light vehicle traffic.
The walkers then moved onto a path that led through a park-like setting for another half mile.
Finally, they ended their walk strolling through a busy, commercial district, with heavy automobile traffic and concrete buildings.
The walkers had been told to move at their own speed, not to rush or dawdle. Most finished the walk in about 25 minutes.
Throughout that time, the portable EEGs on their heads continued to feed information about brain wave patterns to the laptops they carried.
Afterward, the researchers compared the read-outs, looking for wave patterns that they felt were related to measures of frustration, directed attention (which they called “engagement”), mental arousal and meditativeness or calm.
What they found confirmed the idea that green spaces lessen brain fatigue.
When the volunteers made their way through the urbanized, busy areas, particularly the heavily trafficked commercial district at the end of their walk, their brain wave patterns consistently showed that they were more aroused and frustrated than when they walked through the parkland, where brain-wave readings became more meditative.
While traveling through the park, the walkers were mentally quieter.
Which is not to say that they weren’t paying attention, said Jenny Roe, a lecturer at Heriot-Watt’s School of the Built Environment, who oversaw the study. “Natural environments still engage” the brain, she said, but the attention demanded “is effortless. It’s called involuntary attention in psychology. It holds our attention while at the same time allowing scope for reflection,” and providing a palliative to the nonstop attentional demands of typical, city streets.
Of course, her study was small, more of a pilot study of the nifty new, portable EEG technology than a definitive examination of the cognitive effects of seeing green.
But even so, she said, the findings were consistent and strong and, from the viewpoint of those of us over-engaged in attention-hogging urban lives, valuable. The study suggests that, right about now, you should consider “taking a break from work,” Dr. Roe said, and “going for a walk in a green space or just sitting, or even viewing green spaces from your office window.” This is not unproductive lollygagging, Dr. Roe helpfully assured us. “It is likely to have a restorative effect and help with attention fatigue and stress recovery.”
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Many women are aspiring to have Barbie’s look, and, with the help of surgery, they have succeeded in copying Barbie’s physical attributes from head to toe. But it’s not only women who want to look like dolls. Some men are joining the bandwagon, too, modeling themselves after Barbie’s partner Ken.
One man who has gained a lot of attention (and raised eyebrows) is Justin Jedlica, whom the press calls the ‘Human Ken Doll.’
An aesthetic innovator himself, Justin has personally been through 113 surgeries—including lip augmentation, nose reshaping, and pectoral implantation—to hold up to his idea of the perfect man.
Although his exploration of the male aesthetic modification has been a magnet for many criticisms, Justin’s quest for personal fulfillment never wavered. In fact, through his consultation services, he is able to help others in their own quest for aesthetic fulfillment.
What health experts are saying
People can choose to have whatever procedure they want, as long as they are fit to undergo the surgery. The usual scenario is that when a person undergoes one procedure for the first time and is delighted by the results, he or she will most likely have another type of procedure done. Such is the case for Justin Jedlica.
California State University San Marcos professor Natalie Wilson, Ph.D., says that this phenomenon is normal and acceptable. However, David Reath, MD, a plastic surgeon in Knoxville, Tennessee, says he doesn’t see many people having extreme amounts of cosmetic surgery done to their body.
“Sometimes you start working with someone who is reasonable, and the more you work with her/him, you begin to realize you will have to extricate yourself …Knowing if there is a problem starts with figuring out why someone wants the surgery,” Dr. Reath advices.