America's chief doctor called on Americans to support breast-feeding on Thursday and outlined guidelines for mothers and communities to support that most natural nutrition system.

Studies have shown numerous benefits for babies, mothers and overall healthcare when newborns are breast-fed for the recommended minimum of six months.

Surgeon General Regina Benjamin issued a report on Thursday advocating mothers breast-feed their children.

"Many barriers exist for mothers who want to breast-feed," Benjamin said in a statement accompanying the report.

"They shouldn't have to go it alone. Whether you're a clinician, a family member, a friend, or an employer, you can play an important part in helping mothers who want to breast-feed."

Breast-feeding develops immunity in babies and protects them from illnesses like diarrhea, ear infection and pneumonia, according to the report.

Some studies have linked breast-feeding to higher IQs.

Despite the reported benefits of breast-feeding, some women find that with busy schedules, social stigma, and lack of know-how, consistent breast-feeding is difficult to manage.

Although 75 percent of babies start out being breast-fed, just over 1 of 10 are breast-fed exclusively for six months.

The Surgeon General's call seeks to combat those problems by expanding and improving community programs that provide support and peer counseling, and ensuring employers and health care centers to provide similar support.

The American Academy of Pediatrics endorsed the surgeon general's campaign.

"The Call to Action provides a road map for creating a clear path for all mothers to breast-feed as long as they can and wish to do so," the children's healthcare organization said in a statement.

-->Read more...

The specialist: Dr. Scott Nguyen on diverticulitis.

A gastrointestinal surgeon specializing in laparoscopic surgery, Scott Nguyen performs 300 to 400 operations a year. Ten percent of his patients at Mount Sinai have diverticular disease.

Who's at risk

You may never have heard of diverticular disease, but there's a fair chance you have it if you're over 60. Thirty percent of those over 60 have diverticula — pouches in the lining of the large intestine or ­colon.

"The good news is that the pockets themselves only cause problems for 20% to 30% of patients," says Nguyen. "When the pockets cause complications like localized inflammation or infection, we call it diverticulitis."

Another form of diverticular disease is diverticular bleeding, when pockets erode into the blood vessels of the colon and cause bleeding.

As of now, there's no known genetic component to diverticular disease. The primary cause of the disorder is thought to be the modern diet.

"This is a disease of developed countries," says Nguyen. "A low-fiber, high-fat diet is the biggest risk factor, so the obese and people who eat a lot of red meat and other fats are at elevated risk."

Because of the links to fiber, diverticular disease is also possibly associated with constipation.
Your odds of developing diverticular disease increase as you age. Both men and women develop the disease, but often at different points in their lives.

"Most people who develop diverticular disease before age 40 are men, and after age 70 are women," says Nguyen.

Signs and symptoms

The symptoms of both diverticulitis and diverticular bleeding can be extremely disabling.

"The red flag is the acute onset of lower abdominal pain, usually persisting for several hours, up to several days," says Nguyen. "The pain is relatively severe and often associated with a fever,
because it's a type of infection."

If left untreated, the pain often spreads throughout the abdomen and the infection can worsen into a severe infection like sepsis. In some cases the inflammation is so severe that it forms an abscess, erodes into organs like the bladder or blocks the colon.

"Most people have an attack or two of diverticulitis and go to see their doctor for relief," says Nguyen.

Diverticular bleeding is even easier to diagnose, and patients usually head to the hospital immediately. "The sign of diverticular bleeding is the sudden onset of painless rectal bleeding," says Nguyen, "This is profuse bleeding that often leads people to call 911."

The blood tends to be a bright, fresh red, but can also be darker old blood. In some cases, the bleeding is severe enough to cause fainting.

Traditional treatment

The first course of action for preventing or treating diverticular disease is lifestyle modification.

"That means changing your diet, getting exercise, losing weight," says Nguyen. "Unfortunately, it's very hard to change these habits."

During an acute attack, doctors use antibiotics to calm the infection. "Many people respond really well to this," says Nguyen. "But the standard of care is that if you have two or more attacks, you need surgery to remove the diseased area of the colon."

Surgical intervention is called for because these patients are more likely to have a recurrence and to develop complications like abscesses or serious infection.

"For people who had multiple attacks, surgery is successful and prevents another attack about 90% of the time," says Nguyen.

"If we can do it as an elective operation, where we can cool people off with antibiotics, they are usually in and out of the hospital within a week." The results of emergency surgery are much less ideal: Patients usually spend weeks in the hospital for recovery and often need an ostomy bag afterward.

Diverticular bleeding usually calls for admission to the hospital for intravenous fluids and possibly blood transfusions until the bleeding stops. Sometimes a colonoscopy or a special radiologic procedure can be used to halt the bleeding.

"If the bleeding doesn't stop, then we do emergency surgery to remove that section of the colon," says Nguyen.

Research breakthroughs

Doctors are still figuring out how diverticulitis works. "In the past, the traditional school of thought was that diverticulitis in people under 50 was a more virulent form of the disease, so we advocated earlier surgery," says Nguyen. "But now evidence shows that diverticulitis acts the same in young and old — that's a big change in dogma."

Another improvement is in surgical technique. "Laparoscopic surgery is becoming the preferred method, because it has a shorter recovering time and fewer complications," says Nguyen.

Questions for your doctor

If you have an attack of diverticular disease, ask: "What can I do to prevent this from happening again?"

A better lifestyle can protect you against recurrence.

Another essential question is, "Should I get a colonoscopy?" This test will both evaluate the extent of your diverticular disease and check for co-existing cancers.

"Diverticular disease is a sign that it's time to change your life, and it's never too late," says Nguyen. "Even at 90, improving your diet will do its best to correct diverticular disease."

www.nydailynews.com

-->Read more...

A Long Island woman's big toe will adapt to function as a thumb after doctors performed a rare transplant operation to replace the vital missing digit.

Shannon Elliott, 25, lost the thumb and two fingers from her left hand in November when a firework exploded in her palm. Elliott happened to be walking by when someone in a passing car tossed the explosive out a window.

It blew up when she bent to see what had landed and tore apart her hand, reports WABC.

"I was devastated. ... My fingers exploded into pieces," she said.

Stony Brook University doctors suggested the toe amputation to restore mobility to Elliott's hand, and performed an 11-hour surgery after Elliott agreed to go forward.

"To me it was a no brainer. I'd rather lose a toe and gain a whole hand," said the mother of two.

Losing a toe has little effect on a human's ability to walk or run, but losing a thumb nearly incapacitates hand functionality.

Doctors said Elliott will regain full use of her hand in six to nine months.

"She'll be able to pinch and grasp with her hand, she'll be able to hold things and pick up her children," said plastic surgeon Dr. Jason Ganz.

The toe will even adjust in size to better fit Elliott's hand.

"In 1 to 3 years actually, [it will] atrophy," Ganz told WPIX. "It should waste away to where it gets the size of her thumb."

nydailynews.com

-->Read more...

A young farmer who suffered a gunshot wound to the face has received the world's first full facial transplant at a hospital in Spain.

The 24-hour operation, carried out by a 30-member surgical team at Vall d'Hebron Hospital in Barcelona, marks the first time an entire face — including the skin, muscles, teeth, lips, cheekbones and jaw — has been transplanted and reconstructed, using tissue from a brain-dead donor, the Times of London reported.

The transplant recipient, identified only as a man in his 30s, lost his nose, jaw, and other parts of his face when he accidentally shot himself in 2005. He was left with nothing but a hole between his mouth and where his nose should have been, and had been unable to eat, speak or breathe normally for the last five years.

The surgery was carried out March 30.

Dr. Joan Pere Barret, the lead surgeon, said that the procedure was a complete success and that the patient was recovering well in the hospital with no sign of tissue rejection or infection.

"It is a full-face transplant, restoring all the bones and no grafts," Barret told the Times of London. "He has the face of a complete new human being. Relatives say that he looks in some areas like he did before the accident, but he doesn't look like the donor at all. He's changed completely."

Barret said the man asked to see his face seven days after the surgery.

"He was very pleased and satisfied," the surgeon said. "From our point of view, he looks fantastic. He is the best facial transplant ever."

The procedure involved removing the entire facial skin and muscles, nose, lips, palate, teeth, cheekbones and the jawbone from the donor while preserving the blood supply.

The patient's arteries and veins were then isolated and the donor's face checked to ensure that there was a complete flow of blood.

Then bones, nerves and muscles were transplanted and connected to his own blood vessels, nerves and skin. Metal plates were used to support the structure of the new face, which included reconstructing the roof of the mouth.

The patient is able to walk and sits in a chair to watch TV. He is expected to start "talking and eating, and also smiling and laughing" within a few weeks' time, Barret said. "He couldn't talk at all before the surgery, but our plan is that with steroids and other drugs we are considering to allow him to start swallowing next week."

The patient underwent psychiatric tests before the operation to determine if he would be able to confront having a totally new face, the hospital said.

He is likely to remain in hospital for at least two months and will be closely monitored for four months after that. But he should eventually be left with a normal appearance, without scars or distortions in the skin.

Before the transplant, the young man had been operated on nine times, but still had severe difficulty breathing, swallowing and speaking. He had to breathe and be fed through tubes, the hospital said.

Although at least 10 facial transplants have been performed in France, the U.S., China and Spain, all have involved only part of the face. This is said to be the first time a full-face procedure has been carried out.

With News Wire Services

nydailynews.com

-->Read more...