United States

Woman’s tragic death witnessed by family on laptop

A nurse in a Michigan hospital kissed the patient’s forehead. More than 6,000 miles away, Sanaz Nezami’s family in Iran watched on a laptop computer and wept.

Nezami, a vibrant 27-year-old woman who could speak three languages, wanted to pursue an advanced degree in engineering at Michigan Technological University. Instead, she was brain dead just a few weeks after unpacking her bags, the victim of a fatal beating by her new husband, according to police.

Technology allowed family in Iran to watch her final hours. The family’s faith in the hospital staff led to consent for an extraordinary donation: Nezami’s heart, lungs and other life-saving organs were transplanted to seven people in the U.S., a remarkable gift that occurs in less than 1% of all cases.

“We wanted God to perform a miracle and bring Sanaz back to life,” her sister, Sara Nezami, said in a phone interview from Tehran. “But this is a miracle. Sanaz gave her life in order to give life.”

A nurse who took care of Sanaz Nezami said the experience was “eye-opening” for hospital staff.

“The family was willing to trust us to know she wasn’t coming back,” Kim Grutt said.

In August, Nezami married Nima Nassiri in Turkey and lived with him temporarily in the Los Angeles area, where he was born and raised. Her sister said the two met over the Internet.

Nezami, a native of Tehran, had a bachelor’s degree in engineering and a master’s in French translation. She wanted a doctorate degree in environmental engineering.

On Dec. 7, she asked her sister to proofread some English-to-Persian translation she was doing on the side.

“I was shocked,” Sara Nezami said. “Sanaz was a very precise girl, but she omitted some lines. I asked, ‘Are you OK?’ She told me there was no problem.”

The next day, Sanaz Nezami was rushed to a hospital with severe head injuries and was transferred to Marquette General Hospital. Police believe she was assaulted by her husband, who has been charged with second-degree murder. His attorney, David Gemignani, declined to comment.

“Her brain was so swollen and so damaged, there was no longer any blood flow,” explained Gail Brandly, who supervises nurses at the hospital.

No one knew anything about Nezami, so Brandly ran her name through Google. Suddenly, the stranger who couldn’t speak for herself came alive through a résumé posted online.

After about 24 hours, the hospital reached relatives in Iran. Immediate travel to the U.S. was impractical due to visa requirements, so a laptop was set up so the family could see Nezami on life support and talk to nurses and doctors over Yahoo Messenger.

“It isn’t something we’ve done in the past. It’s not every day we’re dealing with family members so far-flung,” said Dave Edwards, spokesman for the hospital.

At one point, Grutt was asked to stroke Nezami’s head and kiss her forehead.

Nezami was buried Dec. 18 in a local cemetery. As a light snow fell, the hospital’s chaplain, the Rev. Leon Jarvis, read Muslim prayers over the casket while about 20 people, mostly nurses and others who cared for her, watched.

Source: detroit free press

Medicaid expansion increased visits to emergency rooms

People newly enrolled in a health insurance program for the poor were more likely to visit the emergency department for care than people who remained uninsured, Boston-area researchers have found, providing the best evidence to date that the national Medicaid expansion that began this week is unlikely to lead to a decline in costly emergency services.

The study was published online Thursday by the journal Science, just as millions of Americans have become newly eligible for Medicaid coverage under the Affordable Care Act. Some politicians have suggested that people who were uninsured and didn’t have a regular doctor or put off basic treatment until their condition became serious, would, once they had coverage, get the primary care they needed to avoid trips to the emergency department.

Previous research on what happened to ER usage in Massachusetts, which expanded its Medicaid program and mandated that most residents have health insurance in 2006, have reached conflicting conclusions. But the new study, of about 25,000 low-income adults randomly selected in 2008 to enroll in Oregon’s Medicaid program, found that the newly insured increased their use of all types of medical care, including prescription drugs, hospital stays, and outpatient visits. Emergency department visits were no exception.

Over an 18-month period, about 42 percent of the new Medicaid enrollees visited the emergency department. In the same period, about 35 percent of those who did not receive Medicaid visited the emergency department.

“Basic economic theory is, if you lower the price, people use it more,” said Amy Finkelstein, a Massachusetts Institute of Technology economist and a senior author on the paper.

It was not a foregone conclusion in this case, however, that reducing the cost of an emergency room visit would increase use, she said, because the cost of a visit to a primary care doctor and of preventive services that may have helped them avoid the emergency room also decreased with insurance coverage.

Yet, emergency department use among those on Medicaid increased during businesses hours, nights, and weekends. While there was no increase in visits classified as non-preventable emergencies, there was an increase for visits deemed preventable or treatable by a primary care doctor.

A 2011 study found that overall emergency department visits increased in Massachusetts in the two years after the state expanded insurance coverage under the 2006 state health care law, though visits for “low severity” problems declined slightly. Dr. Peter Smulowitz, an emergency physician at Beth Israel Deaconess Medical Center and lead author on that study, said he and colleagues have more recently reviewed emergency department use across Massachusetts and found a small increase in pockets of the state that had seen the largest gains in insurance coverage. The study is pending publication.

Data published in the New England Journal of Medicine in 2011, however, found that ER usage was already increasing in Massachusetts and nearby states before the expansion of health insurance coverage here, and that the law did not change the trend in Massachusetts when compared to the other states.

The Oregon study is unique in that it is a randomized controlled study, considered the gold standard in medical research but rarely feasible in health policy research. The state of Oregon created a valuable study scenario when, because the state had money only for a small expansion of the program, it held a lottery for Medicaid coverage, providing insurance to some people and leaving others uninsured.

Past work by principal investigators Finkelstein and Katherine Baicker, a professor of health economics at Harvard School of Public Health, and their colleagues at the National Bureau of Economic Research in Cambridge has found that the lottery winners were more likely to report feeling better about their mental and physical health and had less financial strain, including fewer bills sent to collection. But there was no improvement in key health factors, such as blood pressure or blood sugar levels, as compared with the uninsured.

With the latest study, Baicker said, the body of research out of Oregon has disproved both the worst and best predictions for Medicaid — that it is an expensive program that does little to improve access to care and overall health, or alternatively, that it is a money-saving program that clearly improves health. The results are far more nuanced.

“Policymakers should make decisions based on this evidence that the program has real costs. It’s not free,” she said. “And, it has real benefits. Beneficiaries are clearly better off.”

Source: the boston globe

Flu season kicks in, affect younger adults

The new flu season is ramping up across the U.S. with growing reports of illness — particularly in the south — chiefly caused by the H1N1 bug that is more likely to sicken younger adults than the elderly, health officials said Friday.

Flu activity is increasing nationwide and is already high in six states: Texas, Louisiana, Mississippi, Alabama, Oklahoma and Missouri, officials with the Centers for Disease Control and Prevention said.

For the first time since the 2009 influenza pandemic, H1N1 is the dominant circulating flu strain early in the season, CDC officials said. While most flu strains predominantly sicken the elderly and those with existing health problems, that strain mostly sickens younger adults, those ages 18 to 49, and middle-aged folks, ages 49 to 64.

CDC officials warned earlier this week that they have already received “a number” of reports of serious respiratory illness and death in young and middle-aged adults, including many infected with H1N1 flu. In Texas, where flu is widespread in all areas, a 17-year-old with underlying health problems died, health officials said.

“It’s a reminder that flu can be a serious disease,” said Dr. Joseph Bresee, a CDC flu expert.

So far, there have been no significant changes in the H1N1 flu viruses to suggest they’re spreading more easily or have become more virulent, but CDC officials said they’re monitoring for any signs.

It’s still too soon to tell how serious this year’s flu season will be, or how well this year’s vaccine matches the strains that are actually going around, Bresee said. But, he added, a flu shot is still the best way to avoid illness.

CDC recommends that everyone older than 6 months get a flu shot every year. Federal officials reported earlier this month that flu vaccinations kept nearly 80,000 people out of the hospital last year and prevented 6.6 million cases of the flu.

On average, CDC says 200,000 people are hospitalized with flu each season — ranging from 158,000 people hospitalized in 1990-1991 to 431,000 in 1997-1998. Flu vaccine also may prevent other conditions, such as heart disease, studies show. Flu season typically peaks in January and February.

Still, many Americans, particularly young adults, tend not to get vaccinated.

Source: Nbc news

A boy received lungs after the nation’s organ transplants rules.

Javier Acosta can finally start to breathe easy. The New York boy received a new set of lungs after challenging the nation’s organ transplants rules.

Acosta, as well as Pennsylvania’s Sarah Murnaghan, forced the Organ Procurement and Transplantation Network to change the rules that allowed adolescents and adults to receive organs based on their needs or sickness. Up until now, children had to wait until they turned 12 years old to be put on the waiting list.

Javier had surgery on October 13th after his mother Milagros Martinez successfully filed a lawsuit allowing him to be put on the same list as those over 12. Javier’s mom waited to tell everyone the news about the transplant until he recovered from the surgery.

Javier suffers from the genetic disease cystic fibrosis. The disease is extremely familiar to his family. Javier’s brother died from cystic fibrosis four years ago, just months before he turned 12 and would have been considered an adolescent.

Javier remains under hospital supervision from the transplant. His mother says his prognosis is good and he is “doing fine.”

Source: airing news

Boy stabbed by syringe found in Wal-Mart sweatshirt he got for Christmas

A 16-year-old boy in south Washington is undergoing multiple blood tests after he was stabbed by a syringe hidden inside a sweatshirt he received for Christmas, The Daily News Online reported.

According to Nanette Snyder, her son was modeling the new hoodie – purchased from Wal-Mart – on Christmas day when he stuck his hand in the front pocket. He then felt a stab of pain and pulled his hand out – revealing a syringe stuck in his finger. Another syringe was also found in the sweater’s pocket, and both of the syringes appeared to be used.

Snyder immediately took her son to the emergency room, where he underwent testing for HIV and hepatitis. The family is still waiting for the test results, though the boy will need additional testing throughout the year even if all results are initially negative.

“I feel like crap,” Snyder told The Daily News Online. “It’s a horrible feeling.”

A corporate spokesperson for Wal-Mart said they are investigating the incident.

“We take this very, very seriously and we want to get to a better idea of what could have happened,” she said.

Source: Face Punch

High blood pressure continues to be a bigger problem in Southeastern US

 

One third of U.S. adults have high blood pressure, but in the southeastern part of the country the rate is well over half, according to a new study that finds too little is being done to reverse the problem.

The Southeast has been called the Stroke Belt because of well-known high rates of cardiovascular disease, including high blood pressure. But that knowledge has not led to changes, nor to a full understanding of the reasons for the population’s high risk, the study team reports.

“The rates have not changed,” though the U.S. has had treatment guidelines for high blood pressure since 1977, said one of the authors, Dr. Uchechukwu K. A. Sampson, an assistant professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee.

“The number of people who do not know that they have high blood pressure is the same,” he added.

High blood pressure is an established cause of death from cardiovascular disease and accounts for up to 7.5 million deaths worldwide each year, the researchers point out.

To investigate the persistently high rates of high blood pressure in the South, Sampson’s group used a large database with recent information on men and women in southern states covering the years 2002 to 2009.

They focused on 69,000 white and black adults with similarly low income and education levels – to eliminate poverty as a factor – and analyzed what other causes might be contributing to blood pressure problems.

Overall, they found that 57 percent of the study participants had high blood pressure. Blacks were nearly twice as likely as whites to be suffering from the disease, which has no symptoms of its own, but can lead to stroke or kidney damage if untreated.

But the racial difference was seen mainly among women. Fifty one percent of black and white men had high blood pressure, but the rates were 64 percent among black women and 52 percent among white women.

Obesity seemed to be a main driver of the problem, especially among whites, with the most severely obese having more than four times the risk of high blood pressure compared to normal weight men and woman.

Other factors linked to the likelihood of severe high blood pressure included high cholesterol, diabetes, a history of depression and a family history of heart disease.

The numbers Sampson’s group found have not changed from previous studies and that consistency is alarming, he said.

“Are they still the same factors people have found before?” Sampson said. “If they are, that is bad news, then that means we have not done what we should have done in the past few years.”

Of the study participants who knew they had high blood pressure, 94 percent were taking at least one blood pressure medication, which is a good thing, Sampson said. But only 30 percent were taking a diuretic medication that promotes water loss from the body. Diuretics should be one of the first-line medication options, the authors write.

Black people were twice as likely as whites to have high blood pressure without knowing it, Sampson said.

That racial difference did not change even when researchers accounted for differences in income and education, the authors write in the journal Circulation: Cardiovascular Quality and Outcomes.

All of this lines up with what doctors and researchers already knew, Sampson said.

Without specific studies, it’s hard to say why population rates have not gone down, and why so many people still do not know they have high blood pressure, and why so few are on diuretics, he said.

Women may not actually be more predisposed to high blood pressure, Sampson said, but they may be less aware of the risk than men.

Awareness efforts have historically focused on men when it comes to heart and blood pressure problems, but women are equally likely to have problems, he said.

“African American women are known to have a very high prevalence of hypertension and that its onset is significantly earlier than what is seen in white women,” Dr. John M. Flack said.

Flack is chair of the department of medicine at Wayne State University at the Detroit Medical Center in Michigan.

Source: news.nom

New York facility is ‘last hope’ for girl declared brain dead, family say

The family of Jahi McMath, the 13-year-old girl declared brain dead after complications from routine tonsil surgery, said Saturday a hospital in New York may be able to accept her and keep her on life support.

The girl’s uncle and lawyer wouldn’t provide the hospital’s name, saying they don’t want media attention to hurt her chance of being accepted and transferred there.

“It’s an organization that believes in life,” attorney Chris Dolan told the Associated Press.
“It’s our last, last hope,” he said after two facilities in California that agreed to accept Jahi decided to back out.

A nursing home in the San Francisco Bay Area that had been willing to care for the girl if she had two tubes inserted changed its mind. Dolan said a facility in the Los Angeles area also withdrew its offer because it didn’t want media attention or to jeopardize its relationship with its doctors, who refused to treat someone who’s been declared brain dead.

Time is short for the family, as Alameda County Superior Court Judge Evelio Grillo on Tuesday ruled that the Children’s Hospital Oakland may remove Jahi from a ventilator at 5 p.m. Monday unless an appeal is filed.

Jahi underwent a tonsillectomy at the hospital on Dec. 9 to treat sleep apnea. After she awoke from the operation, her family said, she started bleeding heavily from her mouth and went into cardiac arrest. Doctors at Children’s Hospital concluded the girl was brain dead on Dec. 12 and wanted to remove her from life support. The family said they believe she is still alive.

Before Jahi can be transferred, she must undergo two more medical procedures — the insertion of a breathing tube and a feeding tube.

“Children’s Hospital Oakland does not believe that performing surgical procedures on the body of a deceased person is an appropriate medical practice,” David Durand, its chief of pediatrics, said in a statement Thursday.

Douglas Straus, a lawyer for the hospital, said in a letter made public Friday that before the hospital would comply with the family’s request to move Jahi, it would need to speak directly with officials at any nursing home to make sure they understand her condition, “including the fact that Jahi is brain dead” — and to discuss needed preparations, including transportation.

“Children’s Hospital will of course continue to do everything legally and ethically permissible to support the family of Jahi McMath. In that regard, Children’s will allow a lawful transfer of Jahi’s body in its current state to another location if the family can arrange such a transfer and Children’s can legally do so,” Straus wrote in the letter.

He also said the Alameda County coroner needed to sign off on the move “since we are dealing with the body of a person who has been declared legally dead.”

Dolan said he had already obtained signed consent from the coroner for Jahi’s transfer. The Alameda County Coroner’s Bureau said it had no comment.

He said Saturday he was waiting to hear from the New York hospital after its facility director and medical director speak.

Hospital spokeswoman Cynthia Chiarappa said the hospital has not heard from any facility to discuss how it can accommodate “a deceased body on a ventilator.”

source: Nbc news

Young girl saves her 3 brothers with bone marrow donations

At 13, Julia Jenkins doesn’t always see eye-to-eye with her three little brothers. They can be rowdy and more than a little competitive. But the Jenkins kids share a connection that runs deep.

Julia Jenkins watched one brother get sick and then another and then another. Then she learned that she was the one person who might be able to help save them.

It started in 2008 when Will, then 2, developed a swollen lymph node in his neck. The diagnosis: Burkitt’s lymphoma, a rare cancer of the lymphatic system.

Will started chemotherapy, but then John, who was 6, began having severe stomach problems. “They diagnosed John with Burkitt’s lymphoma two years to the exact day later,” said (mother) Christy  Jenkins.

Doctors at the Aflac Cancer Center at Children’s Healthcare of Atlanta started looking for answers. Burkitt’s doesn’t usually run in families, but a specialist remembered hearing about a rare, genetic immune disorder called XLP carried by boys that could cause very similar symptoms. Blood tests showed both Will and John had XLP, as did 2-year-old Matthew.

“Here I was approached with the plate of, ‘All three boys need a bone marrow transplant to possibly survive,'” said Christy Jenkins.

That’s where Julia comes in.

“I remember getting my blood tested, like sticking a needle in my arm,” Julia Jenkins said.

Julia was a perfect bone marrow donor match for both John and Matthew, but she was so young that she
didn’t even know what being a donor meant.

“But, I said yes, because they’re my brothers,” said Julia Jenkins.

Source: USA news

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 FoxNews.com. “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 FoxNews.com. “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 FoxNews.com. “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

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