Monday, January 16, 2012

London 2012: Mass gathering risks disease spreading

The Olympic Games will see an influx of people to London, from around the world.
Mass gatherings, such as the London 2012 Olympics, can be a hotbed of diseases from across the world, public health experts have warned.

They say it can have consequences for the host nation and for people when they return to their own countries.

There are also important issues to consider in handling large numbers of people, they say.

A series of reports, in The Lancet Infectious Disease journal, has been highlighting the risks.

The theory is that so many people, packed closely together, increases the risk of diseases spreading.

Prof Ibrahim Abubakar, from the University of East Anglia, writes that there are risks from diseases already in the host country and from the home countries of the visitors.

He highlighted religious or music festivals and major sporting events as mass gatherings which could have a public health risk, such as an influenza outbreak during World Youth Day in 2008 in Australia.

One report said increased air travel and the spread of diseases could have "potentially serious implications to health, security, and economic activity worldwide".

The issue for us is to make sure the right system is in place to respond” said Prof Brian McClosky, Health Protection Agency.

The reports also highlight the challenges of managing large numbers of people and pointed to the stampede at the 2010 Love Parade in Germany in which 21 people died and 500 were injured.

Saudi Arabia has to make careful preparations for the world's largest annual mass gathering - the Hajj, with more than two million pilgrims.

Prof Ziad Memish, from the country's Ministry of Health, said: "Conventional concepts of disease and crowd control do not adequately address the complexity of mass gatherings.

"Mass gatherings have been associated with death and destruction - catastrophic stampedes, collapse of venues, crowd violence and damage to political and commercial infrastructure."

Prof Brian McCloskey, who is in charge of the Health Protection Agency's preparations for London 2012, told the BBC: "The history of the Olympic Games suggests infection doesn't happen often.

"The issue for us is to make sure the right system is in place to respond."

He has been improving the agency's disease surveillance to include data straight from hospitals and walk-in centres, which he said would "leave a legacy of probably the most comprehensive disease surveillance system in the world".

Private cosmetic clinics employing 'unqualified' surgeons

Experts voice concerns about level of training of private sector surgeons working on br*ast implants and nose jobs,
Private cosmetic clinics are employing surgeons to carry out br*ast implants, nose jobs and tummy tucks who are not qualified to work as consultants in the NHS, the Guardian can reveal.

Experts are concerned about the level of training and qualification required of surgeons working solely in the private cosmetic industry. Many who trained in the UK reached only a basic level and are not on the General Medical Council's specialist register, which means they are barred from becoming consultants in the NHS. Up to that point, in the NHS, a surgeon is still in training and will normally work under supervision.

The clinics say it does not matter, because their surgeons have years of experience in the procedures they do, which makes them just as good as any NHS surgeon. The private clinics also point out that all meet the standards of the Care Quality Commission, which regulates both the NHS and private sector.

But the revelation has shocked members of the expert group set up by the health secretary, Andrew Lansley, to look into the scandal of substandard br*ast implants and which has been asked to investigate standards in the cosmetic surgery industry more generally.

"I'm very concerned indeed that they are not on the register," said Tim Goodacre, a plastic and reconstructive surgeon at the John Radcliffe hospital in Oxford and a member of the group. "That should be a bare minimum for independent practice in this country."

Doctors who have worked for years as cosmetic surgeons without specialist registration are not breaking the rules and may be more than competent, but the absence of required qualifications means that patients cannot know for sure how skilful they are. Entry on to the specialist register indicates that a surgeon has finished their training and can apply for a consultant post in the NHS.

Plastic surgeons working for the major private healthcare groups, such as Nuffield, BMI and Spire, are all NHS consultants who do some private work as well. The majority of those working for the cosmetic chains, however, such as Transform and the Hospital Group, do not hold NHS posts. Both have some surgeons who are not on the GMC specialist register, although both say this is unnecessary for their work and maintain that their standard of work is as high, if not higher, than that of an NHS surgeon who does private cosmetic operations in his spare time.

Goodacre, however, says it is possible for doctors who were not good enough to progress up the ladder in the NHS to move into the private sector as cosmetic surgeons. "In most other specialities, those who do private practice have got to the top of the tree," he said. "We have this other cadre who have come in because they have not succeeded."

There are growing demands for further regulation of the cosmetic surgery industry, which has always operated very much as a free market, following the br*ast implant scandal. On Saturday, 60 women who had received faulty br*ast implants made by PIP (Poly Implant Prostheses) in France, filled with industrial grade silicone, marched in Harley Street, demanding that private clinics agree to replace them for free.

On Sunday Lansley said private firms currently refusing to replace PIP br*ast implants free of charge were "not stepping up to their responsibilities". The health select committee of MPs is the latest to announce an inquiry into standards in the industry.

Qualifications and the training of cosmetic surgeons will be an issue for the expert group. The two main professional organisations of plastic surgeons in the UK, based at the Royal College of Surgeons, are also concerned about the arrival in the UK of a flood of cosmetic surgeons who qualified in Europe and whose diplomas and certificates, they argue, are not necessarily an indication of reaching the same exacting standards as in the UK – even though the GMC accepts them on to the specialist register.

While there are some outstanding plastic surgeons from Europe working in the UK, others have been trained to a lower standard, says Fazal Fatah, the president of the British Association of Aesthetic and Plastic Surgeons (BAAPS), who holds an NHS consultancy in plastic surgery in Birmingham.

"We very often get applicants from Europe. Although they automatically get on the specialist register, the quality of training they have had is in no way equivalent to a trainee in the UK and they are often not deemed suitable for an NHS post," he said.

"The EU regulations are a significant problem. You can't differentiate between any graduate in Europe. We have lost total autonomy on this heath issue."

There have been concerns about the equivalence of medical qualifications obtained in Europe, compared with those awarded in the UK, since the case of Daniel Ubani, the German-qualified doctor who killed a patient with an overdose of the painkiller diamorphine on his first locum shift in Cambridgeshire.

Submitting evidence to an EU green paper consultation on the issue, the GMC said the "lack of transparency on the nature and content of medical education and training or the skills, knowledge and competencies acquired means that the level of assurance that states can draw from the training obtained by migrants is limited".

An investigation into cosmetic surgery in 2010 by the government-funded but independent organisation NCEPOD (National Confidential Inquiry into Patient Outcome and Death) also expressed concerns, saying: "The present reliance on inclusion in the specialist register does not give any assurance that a surgeon has received adequate training on cosmetic surgery."

BAAPS and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), of which Goodacre is a senior member, believe the equivalence rules, which assume all medical education across Europe is equal, should be re-examined.

"It should be toughened up," said Fatah. He points to the stricter rules in the US, where medical qualifications gained in one state are not always accepted in another and doctors sometimes have to sit new exams to work across the border.

It is hard for patients to judge a surgeon's ability from his CV. Those who are not on the GMC specialist register are often an FRCS (Fellow of the Royal College of Surgeons). This, however, is a basic qualification needed to train as a specialist surgeon in the UK. The gold standard, says Goodacre, is FRCS Plast, which denotes a high level of training and proficiency in plastic surgery. This has only been introduced relatively recently, and Goodacre himself does not have it, even though he has been an examiner for it for 10 years.

Cosmetic surgery is also a global industry. Some private surgeons in the UK also have clinics abroad, whether in Karachi or Rome. Some have qualifications from Brazil, where cosmetic surgery is a huge industry, while others are Fellows of the West African College of Surgeons.

Transform said in a statement that its surgeons were leaders in their field. "The specialist register is applicable only to surgeons working in the NHS. Our surgeons work in the private sector. Therefore this register is not relevant to the highly qualified professional surgeons we employ," it said. "Any suggestion that our surgeons are not adequately qualified or trained is highly offensive and ill-informed."

It added: "Qualifications obtained in other parts of Europe are at least the equal to those obtained in the UK" and said it was "completely untrue and highly misinformed" to suggest otherwise.

"Our surgeons are recruited, appraised, audited, monitored and reviewed to a level that is at the very least commensurate to those employed in the public sector," it said.

The Hospital Group failed to respond to questions.

Mel Braham, owner of the Harley Medical Group, said that all of their surgeons, with the exception of two who were "grandfathered-in" under a Department of Health directive, were on the GMC specialist register in plastic surgery. Some of their surgeons also worked for the NHS as plastic surgeons.

"An important point to bear in mind is that there is no official training for cosmetic surgery in the UK as cosmetic surgery is not available on the NHS. As a result many plastic surgeons working in the NHS have little or no training in cosmetic surgery and far less experience than surgeons working in the private sector," he said.

On Sunday Lansley said private firms currently refusing to replace PIP br*ast implants free of charge were "not stepping up to their responsibilities". He said he had asked Sir Bruce Keogh, the NHS medical director, to convene an expert group to look at the future regulation of the cosmetic service industry. "I think their ability to meet their liabilities towards their patients should be one of the issues we look at,".
Source:Guardian.co.uk

Cosmetic industry offers promise of perfection for the young

A woman receives a neurotoxin botox injection.
Despite concerns about safety, teenagers have shown a growing willingness to embrace cosmetic surgery.
The buzzer sounds, the heavy door gives and you walk into a warm, light, carpeted environment with soft mood music where perfect people gaze at you sidelong from posters on the walls – the men flexing their pecs and the big-eyed girls draped and pouting over their partners. Young women – none over 30 – sit in the cosmetic surgery clinic reception area, each several seats distant from the next, each apparently absorbed in a magazine or mobile.

They look strangely alike – all in long boots, all stick thin and all of them already, to an outsider, very attractive.

It isn't the middle-aged woman, worrying about her crow's feet, who darkens the doors of the cosmetic surgery clinics. It's more often the young, searching for some sort of ideal beauty they think they lack. And according to a market report from Mintel in 2010, while concerns over safety have caused a drop in interest in surgery from adults, there is a growing willingness among teens to contemplate it.

"There has been a sharp rise in the proportion of teens who would consider having cosmetic surgery. The attitudes of today's teenagers could benefit the market for cosmetic surgery in the future. Younger people are more self-conscious about their appearance and more than six in 10 (63%) 16- to 24-year-olds would have surgery to make them feel better about the way they look," the report said.

In a letter to GPs and surgeons on 6 January, the government's chief medical officer, Sally Davies, noted the youth of many who seek cosmetic surgery. "I remain concerned, as chief medical officer, at the high level of cosmetic implants in young people. In particular, the apparent lack of real understanding by recipients of the associated risks," she wrote.

Cosmetic surgery is big business, worth £2.3bn in 2010 and expected to rise to £3.15m by 2015, Mintel said. About 19 million adults would like some sort of cosmetic treatment, the report said. And although the clinics were spending increasing amounts on advertising and promotion, they got enormous help from the media for free.

"Media promotion of unrealistic ideas of beauty continues to influence people's attitudes to their own appearance. However, the media are also improving acceptability of certain procedures, aided by celebrities openly discussing what surgery they've had done," said Mintel.

Because young people, with less money, are the consumers, an industry has grown up that is fiercely competitive on cost. In chat groups, girls exchange tips on what they were charged and how one clinic reduced their costs to match another's price.

But in this busy commercial marketplace, leading plastic surgeons and others worry that medical standards can slip. All the clinics are regulated by the Care Quality Commission, which inspects and approves the premises, including equipment and staffing. But a report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), also in 2010, expressed concerns at the fast turnaround of the clinics. In the time it took to carry out its inquiry, 71 out of 619 private clinics it had approached for information had closed. Of the remaining 548, 371 either did not answer or refused to take part. The investigators wondered whether the one-third of clinics that did respond were "more conscientiously organised" than the rest.

It called for more regulation of what had been called "a problematic cottage industry pattern of laissez-faire provision", saying that even people who eat in restaurants are not forced to inspect the kitchens before they sit down.

The br*ast implants scandal – and the refusal of the more commercial cosmetic clinics to replace substandard implants for free – has fired up the Department of Health to look at greater regulation of the industry.

Sunday, January 15, 2012

I thought I was pregnant but my 'bump' was a melon-sized TUMOUR

Kayleigh Terry now hopes to start a family after recovering
 from having a melon-sized cancerous tumour

A secretary who thought she was pregnant with her first child after piling on the pounds was terrified to discover she actually had cancer.
Kayleigh Terry, 21, had also been suffering from pains and fatigue but was bemused when a pregnancy test came back negative.

A follow-up ultrasound scan revealed she had a large cancerous growth which covered an area from her br*ast to her lower abdomen.
She was diagnosed with Ewing's Sarcoma and had emergency chemotherapy to shrink the potentially deadly tumour.

Kayleigh lost her hair and eye-lashes along with 3st in weight after the shrunken tumour was removed a few months later.
But today after a gruelling two year battle, Kayleigh is celebrating after being given the all-clear and even hopes she may be able to start a family in the future.

Kayleigh of Warrington, Cheshire said: 'I thought I was going to be a mother and I never thought for one moment I had a tumour growing inside me. It just looked for all intents and purposes like a baby bump.
'I just couldn't believe it when I found out what it was. I'm just so relieved to be alive and hopefully I will have children in the future. I'm so excited for everything now. I can't wait to see what 2012 brings.'
Kayleigh was diagnosed with the condition just days after her 19th birthday in July 2009. The teenager was lying in her garden sunbathing at her own barbeque birthday party when her friends commented how far her usually flat belly was protruding.
Kayleigh said: 'It was my 19th Birthday party. I should have been eating cake, I could hardly even manage a sausage, yet my stomach was massive. It didn't make sense.'

The month before the diagnosis she had suffered severe stomach pains, fatigue, loss of appetite and a rapidly growing stomach, and the pains were often so bad that she had resorted to taking hot baths in the early hours of the morning.
Kayleigh said: 'I'd been to the doctors and they said it was something to do with my bowels. Pregnancy entered my mind as I had a boyfriend, but I was on the pill, and as soon as my tummy started to grow I did a test but it was negative.'
Kayleigh then went to her GP complaining of intense stomach pains, underwent blood tests and an ultrasound scan and was told to expect the results in a few weeks, but just days later she received a call.

Kayleigh said: 'I couldn't make it into work the week after, the pains were so excruciating. I was shocked when I received a phone call so quickly about a week later telling me I had to come in.
'I was even more shocked when they showed me my ultrasound and the massive mass on the screen. I'd read about tumours and cancer and asked him if it could be that, he said they weren't ruling cancer out but had no idea what it was inside of me.'

Kayleigh was referred to a specialist at Clatterbridge Centre for Oncology in Wirral, Merseyside who broke the news that she had cancer and required urgent treatment.
Kayleigh said: 'The day I went to see the specialist I was so ill, I'd already been sick, He diagnosed me there and then with Ewings Sarcoma - a rare type of Cancer - and told me I wouldn't be going home. I was in another world and not really with it.'
Kayleigh was told that the tumour had developed suddenly in her soft tissue, rather than bone as was usually the case, and due to its location she would have to begin chemotherapy within 24 hours.
The specialist warned she may not be able to have children afterwards and gave her the option of freezing her eggs, but said this would delay the important treatment.
Kayleigh endured an initial two months of chemotherapy at the Clatterbridge Centre for Oncology, to reduce the tumour from the size of a 'melon' to that of 'a lime' followed by a further four months before it was removed in January 2010.
She endured a further six months of chemotherapy after the operation and spent around a year in and out of hospital altogether, followed by regular three-monthly check-ups.
Kayleigh celebrated the birth of her nephew, Addison in September before moving in with boyfriend Adam in November and, after being officially given the all clear last month, she is now looking forward to a bright future with her family.
Dr Nasim Ali who treated Kayleigh said: 'Kayleigh has had a tumour from the Ewings family of tumours. These behave aggressively and require intensive chemotherapy treatment for a significant length of time, often in addition to surgery.
'Kayleigh was extremely courageous and positive throughout her treatment and from the start has had a positive response to her therapy.
'She remains well at this time and will continue to remain under follow up at Clatterbridge Centre for Oncology for several years.'

Saturday, January 14, 2012

Revealed: World's best quality br*ast implants come from....Cumbernauld

IT is a piece of gel close to many a womans heart and would have remained there had it not been for a nasty piece of profiteering.

Interest in silicone br*ast implants has gone stratospheric since it emerged that French-made PIPs Poly Implant Prothese had been manufactured with cheap industrial-grade silicone instead of the much higher spec medical grade, causing fears of rupturing and cancer.

In the UK, focus has turned to Nagor, the country's only manufacturer of br*ast implants.
Where PIPs are the rather shambolic mopeds of the implant industry, these are the Rolls-Royces and they are made in Cumbernauld.
And while PIPs sold at a rather economical 50 pounds, Nagor implants cost between300 and 500 pounds the difference in this case between quality and ill-health.

Nagor national sales manager Douglas Black said: It is beyond us how you can manufacture something and make a profit to sustain yourself for the long term at that kind of price.
Well, I suppose you can if you do things in certain ways.
Nagor makes around 80,000 implants a year, mainly by hand.
In an era where almost everything is done in conveyor-belt fashion, it is intriguing to watch the care put into every one of these implants.

The atmosphere is clinical in the company's "clean room", the air regularly changed to lower the chance of dust and staff must cover up and scrub in.
The silicone comes from one of only two manufacturers in the world who make medical-grade silicone.
Every barrel is tested to make sure it complies with stringent quality controls.
Operations manager Stephen Barsanti said: "We have four validation points product integrity, user needs, bio compatibility and sterility.
"If we have a power failure, we have to shut everything down, clean it and start again the next day.

"Basically, we lose a day. But it is important that we maintain the integrity of what we are doing."
The shells of the implants are dipped in silicon several times by hand on mandrels or moulds.
When they are ready, they are removed by hand. Each one is then inflated by pressure hose and immersed in water to check for leaks before being closed off and filled with gel.
Any air is sucked out in a vacuum chamber and then any remaining bubbles are removed by hand.
The implants are oven-cured to finish them off before being packed individually for sterilisation.
They will be sent out through an air lock to protect the womb-like lab that gave them birth.
It is the type of procedure designed to reassure women there is quality in an industry which is taking a severe beating from bad publicity.

Douglas has pledged to replace free of charge any PIP implants which have ruptured. He sees himself as a man with a mission to help women who have found themselves, through no fault of their own, at the centre of this fiasco.
But he also wants to reassure them that there is quality control.
At the same time, he is adamant that some form of registry must be created to protect both patients and the industry from this sort of thing ever happening again. He has called upon the clinics and hospitals who have not yet stepped up to the mark to come forward and extend a helping hand to their patients.
He said: "The ethical companies have already come forward but, by anyone's reckoning, that only makes up 16 per cent of the women with implants in this country. That leaves 42,000 women.
"It's about time the people who provided those 84 per cent of women with their implants stopped pointing the finger and started doing something about it. They know who they are.
"People need to be helped first before we find someone to blame and we are trying to be as pro-active as we can to help these patients.
"There's going to be a cost but it can be low and its better than what is being offered out there for these women.
"Some women are being told its going to be another 2800 pounds for something that's not their fault
"Many will have already saved up for these procedures and it is going to be difficult to get that money again. We have got to stop this panic."
Douglas has already written to Health Secretary Andrew Lansley, offering to help, but has yet to receive a reply.
He said: "If the Government is going to help these women as they have said they will, then it is going to cost the taxpayers money and as yet no one has approached us, the country's only manufacturer."
Nagor made their name by working closely with surgeons. They make implants for reconstructive surgery as well as cosmetic work and export all over the world.
As part of their quality control procedures, they send implants to Australia and back and test them for wear and tear.
Black is immensely proud of Nagor's products, designed to match implants with women of all different heights and sizes. He has refused orders for job lots of 20,000 because, as he points out, 20,000 women will not all be the same size and that would just be a case of surgeons putting exactly the same implant in each of them.
It is a difficult time to be in the cosmetic surgery industry but the key, argues Black, is not to shirk on quality.
His hope for the future is a registry. One already exists in the orthopaedic industry where surgeons have told him they can tell within three months if a product is going to work.
Now he wants something similar set up for cosmetic surgery.
He said: "It would holds details of the product, the surgeon and his techniques and the clinic.
"That way, if anything goes wrong, there is a record. If there is something wrong with a product, surgeons should be able to report faults and that will throw up a pattern.
"I am passionate about this. This is a great industry. We give confidence back to so many women.
"We do our job well and all I want is that others should do theirs too."

Woman Gives Birth To Six Babies(sextuplets) In Northern Ireland

A woman has given birth to six babies at a hospital in Northern Ireland, equalling a British record set 26 years ago.

The sextuplets were delivered by Caesarean section at the Royal Victoria Hospital in Belfast between 11.19am and 11.24am yesterday morning. They were said to be doing well despite being born 14 weeks early.

The births equal a record set by the Walton family in Liverpool in 1983, who had six girls. It is believed to be the first case of sextuplets ever recorded in Northern Ireland. Only one in around 4.5 million pregnancies result in sextuplets.

The four girls and two boys weighed between 1lb 7oz and 2lb 2oz and were delivered by a team of 30 medics. All six were in intensive care last night, and their mother is said to be stable. The parents have not yet been named.

Dr Clifford Mayes, who helped to deliver the babies, said: "It is an extraordinary thing to have witnessed, but you are also struck by the fact that there are little babies in intensive care."

He added that staff at the hospital had been preparing for the birth for weeks, making use of technical experts from across Northern Ireland, and confirmed that the children were not conceived through IVF.

"We have planned very carefully for today and it went as well as we had hoped it would," he said. "The care of the babies would be the care we would normally expect for any baby. This is both a happy time and a potentially difficult time."

In 1983, Janet and Graham Walton had six girls, all of whom survived and are now aged 25. Four of them are still living with their parents in Wallasey, Merseyside. Yesterday, Mr Walton said he hoped the mother and father of the six children would "enjoy every minute" of parenthood.

"I would never offer anyone advice on how to raise their children, but as a father of sextuplets, I can say a sense of humour is vital," he said.

Patricia Denvir, the lead midwife in the operation, said the procedure had gone according to plan.

"It is a very stressful situation both for our staff ... and also for the parents, but it's a situation that went very well," she said. "Both parents were very composed and they dealt with it very well. It's a very emotional time."

Patient died after organ operation mix up

Amy Francis was a retired accountant and a widow
A woman died after an experienced surgeon unintentionally attempted to take out the wrong organ during an operating theatre complication.

Amy Joyce Francis, 77, was due to have a kidney removed at the Royal Gwent Hospital in July 2010 but instead the surgeon tried to remove her liver.

The woman from Newport suffered a fatal heart attack after a loss of blood.

The coroner recorded a narrative verdict which was fully accepted by the Aneurin Bevan Health Board.

The inquest was told how Mrs Francis, a retired accountant, underwent keyhole surgery to remove a cancerous right kidney.

Consultant urologist Adam Carter told the hearing that Mrs Francis was to undergo keyhole surgery in order to avoid large surgical wounds and ensure a shorter recovery time so that her left kidney could be treated quicker.

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We appreciated Mr Carter's honesty and him coming along here today and hope that we can put it all behind us now”

Patient's son Alan Francis
Mr Carter said the removal was the easiest part and he asked a trainee present, who had never done it before, to carry it out.

The beginning of the routine operation went as expected with a 2-3 inch incision made in the groin area.

But, the court was told, when it came to removing the kidney, the peritoneal sac was covered by more fluid and matter than usual.

A trainee surgeon was in the theatre that day, and that registrar put her hand in to remove the kidney, but the registrar became unsure, lost her confidence and Mr Carter took over.

He said it was possible that while she was manipulating the organ the thin membrane protecting the liver, the peritoneal sac, was breached.

The inquest then heard how the surgeon felt what he believed was Mrs Francis's kidney and pulled down sharply, a normal procedure for organ removal.

But, the coroner was told, the anaesthetist immediately reported a fall in the patient's blood pressure. Mr Carter said he immediately realised he had pulled on the liver and, as a result, had torn the organ.

Two senior surgeons were called to the scene and efforts were made to save Mrs Francis, but they were unsuccessful.

"I think that what happened is that the peritoneum had been breached and the liver fell down and became more accessible than it usually is," Mr Carter said.

He added that the kidney may well have been pulled down out of place as well.

"I put my hand inside and felt an organ and I pulled it," he added.

Mr Carter said as a result of the death, operating procedure had been modified slightly and the new method communicated "worldwide".

Internal investigation
He said he had carried out the procedure 20 times since the death without a problem.

David Bowen, the coroner for Gwent, recorded a narrative verdict after formally summarising the facts of the case.

"Whilst undergoing keyhole surgery for the necessary removal of the cancerous right kidney, Mrs Francis's liver was ruptured when it was mistakenly and unintentionally identified as the kidney and was catastrophically torn and damaged, resulting in death," he said.

Mrs Francis' son, Alan, said: "We accept the decision and we also accept that Mr Carter and his team acted in good faith to prolong my mother's life."

Speaking outside the court, he added: "We appreciated Mr Carter's honesty and him coming along here today and hope that we can put it all behind us now.

"I think that it was the honesty that saved the hospital. If we thought that they had not answered our questions it would have been different. This was an honest mistake."

After the inquest, a statement from Aneurin Bevan Health Board said it fully accepted the narrative verdict, and its thoughts were with the family and friends of Mrs Francis.

It added: "A full internal investigation was undertaken which examined in every detail every action taken prior to and during the operation.

"The details of this case have been shared nationally by the surgical team with other surgeons involved in the removal of kidneys. Every possible effort was made by the surgical team to save the life of Mrs Francis."

Magnesium-rich diet tied to lower stroke risk

A fresh look at past research concludes that people who eat lots of greens and other foods rich in magnesium have fewer strokes -- a finding that supports current diet guidelines.

But because the research focused on magnesium in food, the authors stopped short of recommending that people take a daily magnesium supplement. It's possible that another aspect of the food is responsible for the finding.

What the results do suggest is that people eat a healthy diet with "magnesium-rich foods such as green leafy vegetables, nuts, beans and whole grains," said lead author Susanna Larsson, a professor at the Karolinska Institutet in Stockholm, Sweden.

Larsson and her colleagues combed through research databases spanning the last 45 years to find studies that tracked how much magnesium people ate and how many of them had a stroke over time.

In seven studies published in the past 14 years, about 250,000 people in the U.S., Europe and Asia were followed for an average of 11.5 years. About 6,500 of them, or three percent, had a stroke in the time they were followed.

For every extra 100 milligrams of magnesium a person ate per day, their risk of an ischemic stroke -- the most common kind, typically caused by a blood clot -- fell by nine percent.

The median magnesium intake for U.S. men and women included in the analysis was 242 milligrams a day (mg/d). The U.S. recommends men and women over age 31 eat 420 and 320 mg/d of magnesium, respectively.

Most of the studies allowed the researchers to rule out other factors, such as family history, from the results, but Larsson told Reuters Health in an email that she cannot say whether other aspects of what the people ate partially or entirely explain the finding.

Because the papers included in the analysis, published in the American Journal of Clinical Nutrition, are so-called observational studies, they also cannot prove that the magnesium is what's actually reducing the stroke risk.

Larsson told Reuters Health that more in-depth studies are needed before researchers can say that.

Dr. Larry Goldstein, director of the stroke center at the Duke University Medical Center in Durham, North Carolina, told Reuters Health that although the findings from reviews like Larsson's are limited, they are consistent with what doctors typically recommend.

"It's a diet that's rich in fruits, vegetables and grains," said Goldstein. "Those are things that have low sodium, high potassium and high magnesium."

Low risk of heart incidents found for marathoners

It's dramatic news when a marathon runner collapses with no pulse. Now a big study finds such calamities are rare and usually due to a pre-existing heart problem.
The study also found such incidents are increasing as more runners try to go the distance.

"You hear about this more and more," said Dr. Aaron Baggish, senior author of the study
Baggish, who runs a program for athletes with heart issues at Massachusetts General Hospital, and co-authors present their analysis in Thursday's issue of the New England Journal of Medicine.

The study covers 10.9 million runners who participated in marathons or half-marathons in the United States from 2000 to 2010.
By scouring media reports and checking with medical staff of races, the researchers identified 59 cases of cardiac arrest, where a runner became unconscious with no pulse during the race or within an hour of finishing. Cardiac arrest is when the heart stops because of a heart attack, a rhythm problem or other disorder.
Forty-two of the runners died.
The overall figures translate to 1 cardiac arrest per 184,000 participants and 1 death per 259,000 participants, the researchers said. Those numbers are low compared to other athletic activities, as shown by prior studies of deaths in college athletes, triathlon participants and previously healthy middle-aged joggers, researchers said.
Most of the cardiac arrests involved marathons rather than half-marathons, and 51 of the 59 cases happened in men.

More cases showed up during 2005-2010 than in the preceding five-year span, but that's just because more people are participating in the races, Baggish said. More worrisome was the finding that among male marathoners, the rate of cardiac arrest per 100,000 runners was higher during the latter half of the decade than in the first half.
Baggish thinks that's because of a shift in attitudes about who can run long distances. Even a decade ago, 26.2-mile marathons were considered appropriate only for very athletic people, he said. But more recently people have come to think of it as "something anyone can do," and even as a healthy activity for lowering the risk of heart disease, he said. So it has attracted people with a family history of early heart disease or early deaths, and "these are just the people who are likely to get into trouble."

In the 31 cardiac arrests for which researchers could find a cause, most were due to clogged, hardened arteries or hypertrophic cardiomyopathy, a sometimes inherited condition in which an unusually thick heart muscle can interfere with the pumping rhythm. Most of the victims were unaware of their pre-existing conditions, Baggish said.
Baggish said he would encourage aspiring and experienced runners to talk to their doctors about their heart risks for distance running.
Dr. Gordon Tomaselli, president of the American Heart Association, called the study "reassuring" for finding so few cardiac arrests. For most people, "running a marathon, if you are so inclined, is a reasonably safe proposition," he said.

Tomaselli, a heart specialist at Johns Hopkins University, also said runners should pay attention if they feel chest pain, dizziness, lightheadedness or unusually short breath or rapid heartbeat while running. "You should listen to your body," he said.
In the same issue of the journal, other doctors wrote a brief report about treating three runners who suffered heart attacks after finishing last year's Boston Marathon. None had cardiac arrest and all survived.

"We don't want to alarm people about marathon running. The benefits of exercise are well established" said one of that report's authors, Dr. Navin Kapur of Tufts Medical Center in Boston. The report shows even seasoned marathon runners can have heart attacks, something paramedics should keep in mind if a runner shows suggestive signs, he said.

Transplant nurse donates own kidney to patient

Transplant nurse Allison Batson donated
 one of her kidneys to Clay Taber
The way Clay Taber looks at it, he’s got three moms now.
There’s the woman who gave birth to him and raised him, of course. Then there’s his fiancée’s mother.
And then there’s the transplant nurse who, though practically a stranger, donated one of her healthy kidneys so that he might start married life untethered to a dialysis machine.
Allison Batson first heard about Taber, now 23, in August 2010, when a charge nurse at Atlanta’s Emory University Hospital told her “it looks like we’ve got an admission from Columbus, Ga. It’s a 22-year-old in renal failure,” Batson recalled.. “It just tore me up.”
Due to a shortage of rooms elsewhere in the hospital, Taber was admitted to the seventh-floor transplant unit, which usually is reserved for patients who’ve already received new organs. Although Batson, 48, wasn’t assigned to care for Taber at first, she stuck her head in his room and said, “I hear there’s a good-looking young man in here.”

Taber had felt fine until right after his 22nd birthday on Aug. 6, 2010, when he started having night sweats. His dad figured it must be nerves, what with him newly graduated from Auburn University and shopping for an engagement ring.
In late August, though, Taber saw a doctor who ordered tests. His mom, Sandra Taber, was grocery shopping when the doctor’s office called to say her son was in complete kidney failure and needed to be hospitalized immediately.
Tests revealed he had Goodpasture syndrome, a rare autoimmune disease that attacks the kidneys or the lungs. Symptoms can appear in a matter of days.

According to the National Library of Medicine, Goodpasture syndrome can be triggered by a viral respiratory infection or by inhaling hydrocarbon solvents. Taber wonders if swimming in the oil-slicked Gulf of Mexico a few weeks before he became ill might be the culprit in his case.
He spent the next month in the hospital, during which he underwent dialysis and plasmapheresis to try to remove the antibodies that had attacked his kidneys. As the weeks passed, Batson bonded with his mother. “I really could relate to his mom and the helplessness that she felt,” says Batson, the mother of four, ages 16 to 27, one of whom has a form of autoimmune arthritis. ”I really felt for her watching her baby go through this.”
Once Taber was strong enough, he was to be placed on the waiting list for a cadaver kidney. Currently, 90,000 U.S. patients are waiting for a donor kidney, according to the United Network for Organ Sharing. Taber says he was told he could expect to wait three to five years.
But Batson had another idea – to offer him one of hers.

“I know this sounds crazy, and it may never happen, but this young man reminds me of one of our kids,” Batson told her husband. “To my knowledge, I was healthy enough, and my kids were grown. I’m just kind of an optimistic person.”
Batson knew Taber couldn’t be transplanted immediately because doctors wanted to be sure his disease was in remission so his immune system wouldn’t attack his new kidney. Last August, when Taber’s mom stopped by to say hello when he was back for a checkup, Batson volunteered her kidney.
“Sandra, you might think I’m weird, but you guys have really been heavy on my mind,” Batson told her. ”I just want you to know that I’m willing to step forward and be tested as a donor.”
Clay Taber says he was “astounded” by her generosity. “I went back and gave her a big hug and told her how much it meant to me. I’ll be honest, I kind of broke down in front of her.”
After tests ruled out the chance of a donation from Taber’s immediate family, Batson was tested and found to be a match. “The only thing I was nervous about in this entire process was that somebody was going to tell us we couldn’t do it,” she says.
Emory has no policy about employees donating organs, spokesman Lance Skelly says. “While we certainly support and applaud Allison’s selfless decision, these are important choices that only a potential donor and his or her loved ones can make.”
The surgery went off Tuesday without a hitch. Batson and Taber hope to be released by Friday evening.
Only about 6,000 living donor transplants are performed each year in the United States, Dr. Nicole Turgeon, Taber’s surgeon, said Friday afternoon at a press conference at Emory. “This is a major reason why we’re here today, to raise awareness about organ donations,” Turgeon said.
Batson expects to return to work in six weeks, and Taber and his fiancée, Laura Calhoun are to be married in June.
“I told [Batson] she’s going to get a special dance at the wedding,” Taber says. “She can pick out the song.”
Would you donate an organ to someone you barely knew? Tell us on Facebook.
Source:msn.com

Thursday, January 5, 2012

The Story Behind Nick Cannon's 'Mild' Kidney Failure

In recent celebrity news, various media outlets are reporting that Nick Cannon, Mariah Carey’s husband and host of America’s Got Talent, has been hospitalized due to ‘mild kidney failure.’

First, I want to clear something up: There’s not such a thing as mild kidney failure. That’s like being a little bit pregnant.
Renal failure is either acute or chronic. Acute renal failure is the fast onset of failure of the kidney to remove waste from your body.
There are many factors that can contribute to kidney failure, ranging from severe dehydration, infection, side effects or toxicity from medications, severe bleeding and auto-immune diseases such as lupus.
Chronic kidney failure tends to develop over a period of years and is mostly due to chronic medical problems like diabetes or high blood pressure. There are some isolated genetic diseases that could also give you kidney disease or kidney failure over time.
However, the most likely explanation behind Nick Cannon’s hospitalization, based on some of the stories circulating, is that he is probably suffering acute renal failure.
Many of the symptoms of acute renal failure are not specific. They include decreased urine output, fatigue, abdominal pain, confusion, and body swelling.
However, if renal failure is not treated, the symptoms worsen. Ultimately, the patient develops seizures, then falls into a coma and could die. This is why I consider the kidney to be one of the most critical organs in the human body.

Now, treatment basically involves treating the underlying cause of renal failure. So, if failure is a result of infection, you would use antibiotics to treat the infection. If the cause is dehydration, you would hydrate the patient. For auto-immune diseases, you would likely use steroid therapy.
Sometimes, you can recover fully from acute renal failure, but in many cases, you can damage the kidney enough that it becomes a chronic disease.
Some of the ways doctors monitor patients for renal failure include blood tests looking for the presence of creatine, and ultrasounds or imaging of kidneys. In some cases, patients may need dialysis to filter out the excess waste that has built up in the body so the kidneys can take a little break.
No matter what, kidney failure is a serious problem, and the media should not trivialize a major health issue. It is important to realize how vital a healthy kidney is to our overall well-being.

 
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