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Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

Saturday, June 9, 2007

The American National Transportation Safety Board has announced that it will make new airline safety recommendations. This comes a result of its investigation into the Comair Flight 5191 disaster, in which a Bombardier Canadair Regional Jet (CRJ) CRJ-100ER crashed whilst attempting take-off from the wrong runway at Blue Grass Airport, Lexington, killing 49 people and leaving just one survivor. The plane was unable to take off because that runway was too short.

The NTSB has now announced that, on July 26, the date on which the NTSB is to determine the probable cause of the accident, they will issue safety recommendations regarding methods of preventing a recurrence of the disaster.

One of the recommendations will concern developing and implementing a cockpit-based system that will inform pilots when they are in the wrong location. Another will involve rescheduling the workloads of Air Traffic Controllers to ensure they receive more sleep, a request they had previously made in April.

Regarding location warning systems, the FAA has pointed out that they have been working on methods of preventing runway incursions (in which a person, ground vehicle or another aircraft is on the runway when or where it should not be), to which the National Transportation Safety Board chairman Mark Rosenker responded “The FAA is doing a great job testing these systems. The question we have is, when will you finally implement that technology?” FAA Associate Administrator Margaret Gilligan responded by saying that they were currently looking at just such a system, adding “We do have airlines that have committed to put that technology on the flight deck once it’s approved”. The system referred to involves runway signal lights and is currently being tested at Dallas-Fort Worth International Airport.

The NTSB will also look at runway and taxiway markings and the ways they can confuse pilots, as this issue has been identified as a contributing factor in the accident. Rosenker said the NTSB was “very interested” in this area. 140 airports have unclear or confusing markings in the US, but it is not certain if Blue Grass Airport is one of them. However, the Air Line Pilots Association (ALPA) made a submission to the NTSB stating that they had found that the markings at Blue Grass Airport did not match those on the charts the pilots were using. ALPA went on to recommend greater standardisation of airport runway markings.

Blue Grass Airport responded yesterday by saying that there was nothing wrong with their runway markings, with spokesman Brian Ellestad saying “We have had numerous inspections before and after (the Comair crash) and have had no issues… FAA reiterates that we meet all requirements for signage, markings, lighting, runways and taxiways.”

Wednesday, August 27, 2008

Operation NANOOK 2008 was held from August 11 to August 25 by the Canadian Forces for the purpose of conducting mock emergency rescue operations for potential maritime disasters in the northeastern Canadian Arctic waters.

Two Canadian navy ships and two airforce planes, a CC-138 Twin Otter and a CP-140 Aurora, took part in the exercises in the Canada’s Arctic. The HMCS Toronto and the Canadian Coast Guard ship Pierre Radisson travelled along the Hudson Strait. The Operation extended to Davis Strait, and Frobisher Bay during the annual NANOOK Operation. There have been 18 such humanitarian operations since 2002. As more Arctic ice melts, the ships sail through uncharted waters. Emergency response times were tested for such potential disasters as oil spills, or rescue operations such as responding to cruise ship emergencies.

General Walter Natynczyk, Canada’s chief of Defence staff, the Honourable Peter MacKay, Defence Minister as well as Minister of the Atlantic Canada Opportunities Agency, and Steven Fletcher, Member of Parliament for Charleswood–St. James–Assiniboia and Parliamentary Secretary for Health, flew to Iqaluit, Nunavut to officially launch the exercise on August 19, 2008 and observe the process.

In addition to the military exercises, Veterans Affairs Canada held a commemorative event onboard the HMCS Toronto to honour the 55th Anniversary of the Cease Fire in Korea, the 65th Anniversary of the Battle of the Atlantic, and the start of the Last 100 days of the First World War. The inaugural ceremonies were held during Community Day activities in the capital city of Iqaluit, followed by the public panel discussion held on Saturday. The community day ceremonies were organized by participants in Operation NANOOK 2008. The public ceremonies received neither Nunavut politicians nor Inuit leaders.

Wednesday, February 22, 2012

Crown Office are staying quiet about possible prosecutions after an inquiry found medical failures caused three deaths at NHS Lanarkshire.

In response to a specific question as to the possibility of prosecutions, a Crown Office spokesperson told Wikinews today that “The three deaths were fully investigated by the Procurator Fiscal and reported to Crown Counsel [laywers] to consider. Crown Counsel concluded that, given the facts and circumstances of the deaths, a Fatal Accident Inquiry (FAI) was the appropriate forum to consider the circumstances of the deaths.” It was further noted that “[a] FAI cannot make any findings of fault/blame against individuals.”

However, Crown Office did not specifically rule out prosecutions for offences such as cuplable homicide despite the spokesperson noting this was a direct response to such a question. They also declined to comment on National Health Service care as “it would not be appropriate to comment on the provision of NHS services” and entirely ignored questions about Crown Office satisfaction in the inquiry’s outcome and the length of time it took to reach a conclusion. The inquiry wrapped up last week but the deaths were in 2006.

Agnes Nicol, George Johnstone, and Andrew Ritchie died within a three-month period following keyhole surgery to remove their gall bladders.

Later expanded to look at all three deaths, the inquiry initially established to look into the case of Nicol, 50, who received surgery in late 2005. A surgeon at Wishaw General Hospital mistakenly cut her bile duct and her right hepatic artery. Whilst suturing her portal vein, her liver was left with 20% of its normal blood supply; the errors were not discovered until her transfer to liver specialists at Edinburgh’s Royal Infirmary.

By then, her liver was seriously damaged. She developed septicaemia, dying from multiple organ failure in March 2006.

Johnstone, 54, underwent the same procedure at Monklands District General Hospital on May 9, 2006. A consultant surgeon accidentally damaged, possibly severing, his bile duct. He died two days later in intensive care from the combined effects of multiple organ failure and a heart ailment.

Ritchie, 62, died in intensive care a week after an operation in June 2006. He died from intra abdominal haemorrhage caused by errors during the surgery.

Different surgeons were involved each time and the inquiry, under Sheriff Robert Dickson, found no evidence of poor training or inadequate experience. Dickson noted that in each case there was lack of action on a “growing body of evidence that there was something fundamentally wrong with the patient” and surgeons failed to contemplate their own actions as potentially responsible. He agreed with two professors that it may have been possible to save their lives “had the post-operative care been to the standard which they expected, and had there been a proper management plan which staff could have worked to” and noted that all the patients suffered from a lack of adequate medical notes being available after their surgery. He described the care as having “clear faults”.

NHS Lanarkshire apologised and said improvements had been made regarding “these types of cases” as well as with document management. Wikinews got in touch seeking details of the changes made but the health trust failed to respond.

Friday, January 4, 2013

Opposition activists in Syria say nine or more people have died as the result of a car bomb explosion at a fuel station in the Barzeh al-Balad district of Damascus, the capital of the country, according to BBC News Online. News agency Reuters has placed the minimum death toll at eleven while also reporting at least forty injuries. The Syrian Observatory for Human Rights believes an increase in the number of fatalities recorded is probable.

At the time of the incident, a large number of people were waiting at the station to collect petrol. Activists say Syria is short of petrol because of the ongoing civil war, which started during 2011. BBC News Online says drivers queueing at fuel stations for hours is a frequent occurrence in the country.

An unidentified activist told Reuters the fuel station was “usually packed even when it has no fuel. There are lots of people who sleep there overnight, waiting for early morning fuel consignments”. The same person reported witnessing the bodies of burned people being placed onto ambulances, as well as those with wounds and severe burns, and vehicles the blast had destroyed being towed away. The activist, a local resident, said security workers at the station then told him to leave the scene.

The Revolution Leadership Council, which is part of the Syrian opposition, cited “a booby-trapped car” as the source of the explosion. It is unclear at this stage as to who was responsible for the incident, although the local activist who spoke to Reuters said there had been increased conflict between civilians and militia supportive of Syrian President Bashar al-Assad at fuel stations recently.

Thursday, March 1, 2007

Mullah Dadullah, a high ranking official for the Taliban in Afghanistan, has said that the leader of al-Qaeda Osama bin Laden is “still alive” and that “messages are exchanged to share plans” with Bin Laden. Dadullah also said that they “go to the battlefield together.”

“Only his comrades see him; we exchange messages with each other to share plans. We also go to the battlefield together. We actually meet very rarely, just for important consultations. It’s hard for anyone to meet Bin Laden himself now, but we know he’s still alive,” said Dadullah.

Dadullah also claims that there are “hundreds” of suicide bombers that are prepared and ready to hit the NATO peacekeeping forces in Afghanistan and that Americans will “reap the crop for a long time” also saying that the Taliban and al-Qaeda will get “revenge” on the United States either inside or outside Afghanistan.

“The Americans have sown a seed. They will reap the crop for quite a long time. We will get our revenge on them, whether in Afghanistan or outside,” said Dadullah.

“The suicide martyrs, those willing to blow themselves up, are countless. Hundreds have registered their names already and are ready to go and we have hundreds more on the waiting list. Each is anxious to be the first to be sent,” added Dadullah.

Dadullah also says that Islam “is more important than anything.”

“For the Taliban, Islam is more important than anything else. It’s our religious duty to shelter any Muslim brother who’s on the run from the infidels, even at the cost of our government.”

So far, the U.S. has not been able to confirm or deny the information and Dadullah has not stated where bin Laden may be hiding.

Thursday, January 6, 2005

Friends of the son of the Brazilian President, Luis Inacio Lula da Silva, have published photos of themselves partying on vacation in Brasilia. The news caused arguments and protests amongst many Brazilians, with allegations that the government were paying the expenses.

The group of teenagers is shown cavorting at the official residences of Granja do Torto and Palácio do Alvorada, both in Brasilia; near a Brazilian Air Force airplane; travelling by motor boat in Paranoá lake; and with Brazilian soccer player Pelé.

At first, the photos appeared in the photoblogs www.fotolog.net/tata_lulu, www.fotolog.net/feijao_fodao and www.fotolog.net/gringo_mi. But since the publication of the news by the local newspapers Folha de São Paulo and Estado de São Paulo, the photoblogs were deleted or the photos removed. Some of the photos however, still are available at some user and newspaper sites on the Internet.

Since the incident, several people have created Orkut communities which comment, joke, and protest about what has happened. One of these communities, named “Férias na Alvorada – EU QUERO!” (Vacations at Alvorada – I WANT IT!”), had 450 members as of January 7th.

The Brazilian government declined to comment on the pictures.

Monday, March 20, 2006

Fears of contaminated bone and skin grafts are being felt by unsuspecting patients following the revelation that funeral homes may have been looting corpses.

Janet Evans of Marion Ohio was told by her surgeon, “The bone grafts you got might have been contaminated”. She reacted with shock, “I was flabbergasted because I didn’t even know what he was talking about. I didn’t know I got a bone graft until I got this call. I just thought they put in screws and rods.”

The body of Alistair Cooke, the former host of “Masterpiece Theatre,” was supposedly looted along with more than 1,000 others, according to two law enforcement officials close to the case. The tissue taken was typically skin, bone and tendon, which was then sold for use in procedures such as dental implants and hip replacements. According to authorities, millions of dollars were made by selling the body parts to companies for use in operations done at hospitals and clinics in the United States and Canada.

A New Jersey company, Biomedical Tissue Services, has reportedly been taking body parts from funeral homes across Brooklyn, New York. According to ABC News, they set up rooms like a “surgical suite.” After they took the bones, they replaced them with PVC pipe. This was purportedly done by stealth, without approval of the deceased person or the next of kin. 1,077 bodies were involved, say prosecuters.

Investagators say a former dentist, Michael Mastromarino, is behind the operation. Biomedical was considered one of the “hottest procurement companies in the country,” raking in close to $5 million. Eventually, people became worried: “Can the donors be trusted?” A tissue processing company called LifeCell answered no, and issued a recall on all their tissue.

Cooke’s daughter, Susan Cooke Kittredge, said, “To know his bones were sold was one thing, but to see him standing truncated before me is another entirely.” Now thousands of people around the country are receiving letters warning that they should be tested for infectious diseases like HIV or hepatitis. On February 23, the Brooklyn District Attorney indicted Mastromarino and three others. They are charged with 122 felony counts, including forgery and bodysnatching.